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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343603027
Report Date: 05/04/2020
Date Signed: 05/04/2020 10:12:08 AM

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 - SAN JUAN (INF)FACILITY NUMBER:
343603027
ADMINISTRATOR:ALLRED, DAWNAFACILITY TYPE:
830
ADDRESS:5448 SAN JUAN AVENUETELEPHONE:
(916) 961-5599
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:36CENSUS: 10DATE:
05/04/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Dawna AllredTIME COMPLETED:
10:15 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
At 9:25 a.m., on Monday, May 4th, 2020, Licensing Program Analyst (LPA) Karyn Guerra conducted a tele-inspection and met with Director, Dawna Allred, for the purpose of a case management inspection regarding an unusual incident that occurred at the facility on April 20th, 2020. Director self-reported the incident to the department on Tuesday, April 21st, 2020. During today's inspection, LPA conducted interviews and requested documents.

No Title 22 Deficiencies were cited during inspection. LPA reviewed report with Director. Typed name in Facility Representative signature field denotes electronic signature of Director. A copy of the report and Notice of Site Visit will be provided. Notice of Site Visit must remain posted at facility for 30 days.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2020
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 1