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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615313
Report Date: 03/03/2023
Date Signed: 03/03/2023 10:44:57 AM


Document Has Been Signed on 03/03/2023 10:44 AM - 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 FLORINFACILITY NUMBER:
343615313
ADMINISTRATOR:CHAVEZ, ANGELAFACILITY TYPE:
850
ADDRESS:9250 ELK GROVE FLORIN ROADTELEPHONE:
(916) 714-2772
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:104CENSUS: 47DATE:
03/03/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Stephanie ChavezTIME COMPLETED:
10:50 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
On March 3, 2023, Licensing Program Analyst (LPA) Salene Mayberry met with Interim Director Stephanie Chavez for the purpose of an unannounced case management visit. Census included 47 children being supervised by 5 staff members.

LPA learned that from December 4th through December 16, 2022, five children tested positive for Hand Foot and Mouth disease (HFM). A review of the Community Care Licensing file by LPA confirmed that the facility had failed to notify Licensing of the outbreak. LPA discussed Reporting Requirements, Section 101212, with the Interim Director during the visit and provided her with a copy of the regulations.

A Type B deficiency was cited on the subsequent page (LIC809-D) of this report.

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 provided 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: 03/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
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 2


Document Has Been Signed on 03/03/2023 10:44 AM - 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
FACILITY NUMBER: 343615313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2023
Section Cited

1
2
3
4
5
6
7
101212 Reporting Requirements(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (1) below, a report shall be made to the Department…(E)Epidemic outbreaks. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Interim Director will review reporting requirements. Interim Director will also complete and submit an Unusual Incident Report for the outbreak of HFM in December 2022 to LPA.
8
9
10
11
12
13
14
LPA learned that five children at the center contracted Hand Foot and Mouth disease (HFM) between 12/4 to 12/16/22 and that the outbreak was not reported to Licensing. This poses a potential risk to health and safety of children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 03/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/03/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2