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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343603013
Report Date: 02/07/2023
Date Signed: 02/07/2023 01:41:19 PM


Document Has Been Signed on 02/07/2023 01:41 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:KINDERCARE LEARNING CENTER - PEETS (SA)FACILITY NUMBER:
343603013
ADMINISTRATOR:MORENO, AMYFACILITY TYPE:
840
ADDRESS:9150 PEETS STREETTELEPHONE:
(916) 684-9284
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:28CENSUS: 6DATE:
02/07/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Bekah ScovelTIME COMPLETED:
02:00 PM
NARRATIVE
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On 02/07/2023, Licensing Program Analyst Katy Maestas (LPA) conducted a field visit to the facility for the purpose of a case management inspection. LPA arrived at the center and was met by Director Bekah Scovel (D1). LPA disclosed the purpose of the inspection and was granted entrance into the facility. LPA conducted a tour of the facility and observed 14 infants being supervised by 4 staff members, 12 preschool aged children being supervised by 2 staff members, and 6 school aged children being supervised by 1 staff member. LPA determined, through accessing Guardian, that 1 individual on location was not associated to the license. D1 had requested a fingerprint transfer on 02/06/2023; however, the transfer had not yet taken place nor did D1 attempt to confirm through Guardian OR Officer of the Day that said individual was cleared or associated. As a result, a Type-A deficiency was cited on a subsequent 809-D page with a civil penalty. D1 understands that all parents or authorized representatives of currently enrolled children (under license #343603013) must sign the LIC 9224 form and be available to the Department for review. D1 understands that parents or authorized representatives of children enrolling (under license #343603013) for up to one year must sign the LIC 9224 form and be available to the Department for review.
An Exit Interview was conducted in which the report was reviewed and discussed with the D1. A Notice of Site visit was provided and posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
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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Document Has Been Signed on 02/07/2023 01:41 PM - 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833


FACILITY NAME: KINDERCARE LEARNING CENTER - PEETS (SA)
FACILITY NUMBER: 343603013

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/08/2023
Section Cited

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(i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall:...
(2) Request a transfer of a criminal record clearance as specified in Section 101170(f).
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LPA will immediatley access Guardian and transfer Marissa Dupuy. D1 will not allow Dupuy on location until she confirms clearance through LPA or Officer of the Day. D1 will request a PIN number from Guardian and familiarize herself with the website.
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This requirement was not met as evidenced by LPA observing Marissa Dupuy at the facility on 02/07/2023.
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D1 will call Officer of the Day and inquire about fingerprints and associations PRIOR to any individual being on location that will provide care and supervision to children in care.

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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: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2023
LIC809 (FAS) - (06/04)
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