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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334808839
Report Date: 11/28/2023
Date Signed: 11/28/2023 01:53:48 PM


Document Has Been Signed on 11/28/2023 01:53 PM - 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 ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334808839
ADMINISTRATOR:IVAMAE HANEYFACILITY TYPE:
850
ADDRESS:1655 HIDDEN VALLEY PARKWAYTELEPHONE:
(951) 898-5677
CITY:CORONASTATE: CAZIP CODE:
92879
CAPACITY:102CENSUS: 49DATE:
11/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Ivamae Haney, DirectorTIME COMPLETED:
02:03 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. It was noted on November 10, 2023 a child was picked up soiled. It was also noted the child obtained a mark on the leg while in care and was left inside while all the other children went outside.

During the inspection, records were reviewed and interviews were conducted. During interviews it was disclosed the child never asked to use the restroom and did not act to be in any discomfort which would have prompted the Staff to take the child to the restroom. Staff did not observe the child being soiled. Staff also stated they did not observe a mark on the child’s leg. Staff stated on the day the child was allegedly left alone in the classroom, he/she was assigned to clean the classroom restroom. Upon walking into the classroom Staff observed all children were walking out of the classroom together with two Staff to the outdoor play area. He/she did not observe any children present inside of the classroom and proceeded to clean. Based on information gathered, the facility acted appropriately, and no violations have been identified. The Director met with the Authorized Representative immediately and reported the incident to Licensing according to the Title 22 regulations.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse JonesTELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
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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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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334808839
VISIT DATE: 11/28/2023
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A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director, Ivamae Haney.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse JonesTELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2