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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615335
Report Date: 06/22/2023
Date Signed: 06/22/2023 01:33:16 PM


Document Has Been Signed on 06/22/2023 01:33 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:KINDERCARE LEARNING CENTER - ELK GROVE FLORINFACILITY NUMBER:
343615335
ADMINISTRATOR:CHAVEZ, ANGELAFACILITY TYPE:
830
ADDRESS:9250 ELK GROVE FLORIN ROADTELEPHONE:
(916) 714-2772
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:24CENSUS: 25DATE:
06/22/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Suzanna CervantezTIME COMPLETED:
01:45 PM
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On 06/22/2023, Licensing Program Analyst Jennie Tedlos (LPA1) and Licensing Program Analyst Katy Maestas (LPA2) conducted a field visit to the facility for the purpose of a case management inspection to follow up on a self reported Unusual Incident Report (UIR). LPAs arrived at the facility and disclosed the purpose of the inspection and were granted entrance. Acting Director Suzanna Cervantes (D1) arrived shortly after LPAs arrival. LPAs toured the facility and observed 25 infants being supervised by 6 staff members. LPAs accessed Guardian to determine that all required adults were background cleared and associated to the license. LPAs conducted staff interviews, reviewed records, and observed care and supervision of children in care. LPA1 requested a copy of the Facility Roster.

In the areas that were evaluated today, no deficiencies were cited. An exit interview was conducted, and the report was reviewed with D1. LPA provided D1 with Licensee Appeal Rights. 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) 215-3003
LICENSING EVALUATOR NAME: Jennie TedlosTELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2023
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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