364804211-10-20-2022-09-CC-ASHA-CKDS7A-20221020133712

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364804211
Report Date: 10/20/2022
Date Signed: 10/20/2022 01:37:22 PM

Document Has Been Signed on 10/20/2022 01:37 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	364804211
ADMINISTRATOR:	MELINDA GASKIN		FACILITY TYPE:	850
ADDRESS:	2140 S. EUCLID		TELEPHONE:	(909) 983-5007
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	72	CENSUS: 50	DATE:	10/20/2022
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	12:04 AM
MET WITH:	Megan Peveler		TIME COMPLETED:	01:45 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 this date and time, Licensing Program Analysts (LPAs) Aman Sharma and Justin Giese conducted a case management incident investigation. LPAs met with director Megan Peveler and were granted access into the facility. LPAs toured the facility and took census. On 09/28/22 it was self reported by a teacher and the director that during parent drop-off, a teacher was not made aware of a child arriving at the daycare, resulting in a child being left outside alone. Of the two staff that were mentioned in the incident report, 2:2 staff stated that the child was left by the parent of the child in the playground area. One staff mentioned the child was dropped off by the parent in the playground area and never made any type of verbal or eye contact with the teacher. The child was not noticed at all for at least one minute, according to the teacher who was in the playground at the time. Based on facility's own admission via Unusual Incident Report (UIR), and staff interviews, the preponderance of evidence standard has been met, meaning the incident did occur. Please see attached LIC809D for Type A Deficiency. A Civil Penalty of $500 will be assessed during this investigation for a violation of Responsibility for Providing Care and Supervision. Facility was cited on 10/20/2022 for failure to provide care and supervision. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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 10/20/2022 01:37 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364804211
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/20/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/21/2022 Section Cited	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision - No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement has not been met as evidenced by:
	8 9 10 11 12 13 14	Based on Interviews and faciity's own admission via UIR, staff were unaware a child was left unattended in the playground area for at least one minute. This poses an immediate health and safety risk to the children in care.	8 9 10 11 12 13 14	of topics discussed regarding the importance of child drop off, name to face transitions and making sure there is a sign in/out area available to parents. Documentation of training/proof of correction will need to be submitted to licensing no later than POC due date.
	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: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364804211
	VISIT DATE: 10/20/2022

NARRATIVE

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LPAs issued a Notice of Site Visit and verified it was posted in a prominent location at the facility. Director understands that the Notice of Site Visit must remain posted for the next 30 days along with a copy of all Type A deficiencies cited during this inspection. A copy of all Type A deficiencies cited during this inspection must also be immediately (within 24 hours of child’s next day in care) given to the parents of all children enrolled in the child care facility and any children enrolled into the child care facility over the next 12 months (at the time of enrollment). Director is required to have all parents sign and date the Acknowledgement of Receipt of Licensing Reports (LIC9224) and maintain a copy in each child’s file. A copy of this report, LIC9224 and Appeal Rights (LIC9058) were provided during this inspection.

An exit interview was conducted with director, Megan Peveler and LPAs provided the Director with a copy of this report.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 805-5718
LICENSING EVALUATOR NAME: Aman Sharma	TELEPHONE: (951) 970-7385
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC809 (FAS) - (06/04)

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