<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804330
Report Date: 02/21/2023
Date Signed: 02/21/2023 10:33:01 AM


Document Has Been Signed on 02/21/2023 10:33 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804330
ADMINISTRATOR:THERESA SALLEYFACILITY TYPE:
840
ADDRESS:11961 PERRIS BLVDTELEPHONE:
(951) 243-6558
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:42CENSUS: 0DATE:
02/21/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Theresa SalleyTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/21/23 at 09:15 AM, Licensing Program Analysts (LPAs) Sumayya Habeebulla and Jessica Rubio, conducted a Case Management visit in response to information received from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW). LPAs met with Director, Theresa Salley who was informed of the reason for the visit.

Assembly Bill 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers constructed before January 1, 2010, to test their drinking and cooking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first lead testing. LPA observed on the report provided by the SWRCB the FAUCET B (Drinking Water Fountain) identified as having high levels of lead.

The faucet is located in the School Age Classroom B. The Director stated the faucet has been replaced but not retested yet. The Drinking water faucet is not currently being used. The Director stated she will be scheduling the retest for the specified faucet soon and will keep the Department updated about the results.

Interviews with staff revealed that the children have not used the drinking water fountain yet.

See LIC 809D for cited deficiency in accordance with the California Code of Regulations Title 22, Division 12 written directives.

During the Exit interview LPAs informed the Director to submit retesting for each classroom under the correct License numbers.

An exit interview was conducted with the Director Theresa Salley. A copy of this report, appeal rights and a Notice of Site Visit was issued.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 02/21/2023 10:33 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804330

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2023
Section Cited

1
2
3
4
5
6
7
California Lead Action Level at Child Care Centers(b) Testing results...ppb readings of 0.5 ppb or greater...(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility has placed the water outlet out of order and is providing drinking water to children in a pitcher with disposable cups. The faucet has been replaced and will not be used until retested and no longer has an exceedance.
8
9
10
11
12
13
14
LPA received the facility's water testing results for Faucet B with an Action Level Exceedance higher than the allowable limit.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2