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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804211
Report Date: 05/14/2024
Date Signed: 05/14/2024 02:52:58 PM


Document Has Been Signed on 05/14/2024 02:52 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804211
ADMINISTRATOR:MEGAN PEVELERFACILITY TYPE:
850
ADDRESS:2140 S. EUCLIDTELEPHONE:
(909) 983-5007
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:96CENSUS: 50DATE:
05/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Megan PevelerTIME COMPLETED:
03:15 PM
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A Case Management inspection is being conducted in response to the receipt of an Unusual Incident Report (UIR) from the facility. Licensing Program Analysts (LPAs) Blanca Ruiz and Elyse Jones met with the Director, Megan Peveler to follow up on the UIR submitted to the department. Facility was toured and census was taken. Parent(s)/Legal guardian of child(ren) of the involve in the incident are aware of all details. Interviews were conducted with pertinent parties and records were reviewed. Facility serves age group: 2 to 5 years of age. Observations were conducted during daycare hours and the area where the incident occurred was inspected to verify substantial compliance.

On 04/23/2024 at approximately 4:00 p.m. during transition from nap time to outside play, children were line up to go to the playground. Child#1 and Child#2 were racing to the playground structure to go down the slide. Staff#1 observed when Child#2 pushed Child#1 as child was squatting to go down the slide. Child#1 lost his/ her balance and fell down from the small play structure. Staff#1 was in close proximity to both children and attended to Child#1. As the child got up, Staff#1 and Staff#2 noticed child’s left arm was not straight. Immediately after incident took place, facility provided first aid and contacted parent(s)/Legal guardian(s). Incident was also reported to licensing in a timely manner. Child was taken to urgent care, and it was determined that his/her arm was broken. Child#1 returned to the facility the following week after the incident and the child is still in care. Staff #1 and Staff#2 were attending to 24 children when the incident occurred. After the incident, children have been redirected to take turns as they walk to the playground to prevent any future incidents. Based on information gathered, the facility acted appropriately and no violations have been identified at this time.
An exit interview conducted, and report was reviewed with licensee, Megan Peveler. Appeal rights were discussed, and A Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

THIS REPORT MUST BE AVAILABLE TO THE PUBLIC, UPON THEIR REQUEST, FOR THREE YEARS.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Blanca Ruiz-SilvaTELEPHONE: (951) 233-5594
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024
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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