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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615313
Report Date: 12/20/2022
Date Signed: 12/20/2022 07:12:58 PM


Document Has Been Signed on 12/20/2022 07:12 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 - ELK GROVE FLORIN (PS)FACILITY NUMBER:
343615313
ADMINISTRATOR:CHAVEZ, ANGELAFACILITY TYPE:
850
ADDRESS:9250 ELK GROVE FLORIN ROADTELEPHONE:
(916) 714-2772
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:104CENSUS: 42DATE:
12/20/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Stephanie ChavezTIME COMPLETED:
07:35 PM
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On December 20, 2022, Licensing Program Analyst (LPA) Salene Mayberry met with Interim Director Stephanie Chavez for the purpose of a case management visit to discuss deficiencies.

During the visit it was determined that four uncleared adults have been working in the center. The uncleared adults do not have Department of Justice fingerprint clearances. Records indicate that uncleared adult #1 had their fingerprints submitted to Live Scan on 5/12/22, and the application was closed as “Incomplete” on 8/10/22. Uncleared adults #2, #3 and #4 are not associated to this facility.

A Type A deficiency was cited on the subsequent page (LIC9099-D) of this report.

Upon receipt of Type A citations, Licensee shall post and provide copies of the LIC9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC9224, Acknowledging Receipt of LIC9099-D in each child's file

An Exit interview was conducted, and the report was reviewed and discussed with the Interim Director. Appeal Rights and a copy of the report was printed and provided to the Interim Director. A Notice of Site Visit was 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: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene MayberryTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2022
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 12/20/2022 07:12 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 - ELK GROVE FLORIN (PS)
FACILITY NUMBER: 343615313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/21/2022
Section Cited

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101216 Criminal Record Clearance (i) Prior to employment or initial presence in the child care center, all employees and volunteers subject to a criminal record review shall obtain a California clearance. This requirement was not met as evidenced by:
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Interim Director stated she will have uncleared adult #1 live scanned for criminal record clearance and adults #2, #3 and #4 associated her to the facility. Interim Director will submit verification of live scan and association to LPA by POC Date: 12/21/22.
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LPA observed 4 adults working in the facility without a criminal record clearance. This is an immediate risk to the health and safety of 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: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene MayberryTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2022
LIC809 (FAS) - (06/04)
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