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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804332
Report Date: 02/02/2021
Date Signed: 02/02/2021 04:53:31 PM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804332
ADMINISTRATOR:RUBALCABA,BRANDIEFACILITY TYPE:
850
ADDRESS:5445 CANYON CRESTTELEPHONE:
(951) 683-1626
CITY:RIVERSIDESTATE: CAZIP CODE:
92507
CAPACITY:96CENSUS: 36DATE:
02/02/2021
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Brandie Rubalcaba, Director TIME COMPLETED:
11:00 AM
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Due to COVID-19, Licensing Program Analyst (LPA) Sharleen Robinson conducted a Tele-inspection with Director Brandie Rubalcaba. The Case Management follow up Tele-inspection was held to follow up on an unusual incident that occurred on January 20 2021. LPA Met with the Director via Zoom, (the Director did not have access to other platforms). Per the Director there were 36 children in care. The Director toured LPA through the facility where the incident occurred. LPA conducted interviews and requested records.

The Director reported the following; on January 20, 2021 at approximately 1:00pm Staff #1 was supervising 9 preschool children on the playground, when Staff #1 witnessed Child #1 running, loose their footing, slip and fall landing on their right leg. Staff #1 immediately provided first aid to the child, and advised the Director of the incident. The Director notified the child’s representative. The Child’s representative took the child to seek medical attention on or about January 20, 2021, the child was diagnosed with a fractured right shinbone.

During interviews it was disclosed that Staff #1 witnessed Child#1 running on the playground, Staff #1 advised Child#1 to stop running. As Staff #1 turned their head to scan the playground, simultaneously Child #1 fell. Staff #1 was near the child when the incident occurred but could not get to the child in time to prevent the child from falling. As of February 2, 2021 the child has not returned to the facility. The child is scheduled to return to the facility within three to six weeks, after they are healed.

Based on the information obtained during the visit, as well as an inspection of the playground there appeared to be no violation of Title 22 Regulations pertaining to the reported incident. No deficiencies cited at this time.

LPA Robinson provided the Director with a copy of this report and notice of site visit via email with an electronic “read receipt”. LPA asked the Director to acknowledge receipt of the email. The electronic read receipt of the emailed report acknowledges receipt of this report and notice of site visit. A copy of this report and notice of site visit was emailed to the Director during this Tele-inspection on February 2, 2021. Director advised the notice of site visit must be posted in a prominent location for the next 30 days.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Sharleen RobinsonTELEPHONE: (951) 233-7183
LICENSING EVALUATOR SIGNATURE:

DATE: 02/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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