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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334805787
Report Date: 05/30/2019
Date Signed: 05/30/2019 04:11:33 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:
334805787
ADMINISTRATOR:EVA HERNANDEZFACILITY TYPE:
840
ADDRESS:7920 LIMONITE AVENUE, SUITE GTELEPHONE:
(951) 681-1440
CITY:RIVERSIDESTATE: CAZIP CODE:
92509
CAPACITY:65CENSUS: 9DATE:
05/30/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Assistant Director - Emily Calhoun-SalasTIME COMPLETED:
04:20 PM
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A case management visit is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. The UIR was received by the licensing agency on 05/14/2019.

The report received was regarding the incident that occurred on 05/13/2019 at about 4:15PM where an inappropriate action between two School age children happened on the playground.

LPA Huynh reviewed facility records, obtained statements from facility staff and conducted interviews with pertinent parties. Based on information gathered, the facility acted appropriately and no violations have been identified.

An exit interview was conducted, and a copy of this report was provided to facility staff.

SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: John HuynhTELEPHONE: (951) 529-2439
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
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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