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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804215
Report Date: 05/19/2023
Date Signed: 05/19/2023 10:27:20 AM


Document Has Been Signed on 05/19/2023 10:27 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804215
ADMINISTRATOR:ASHLEY MORALESFACILITY TYPE:
840
ADDRESS:10191 FOOTHILL BLVDTELEPHONE:
(909) 989-6136
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:48CENSUS: 0DATE:
05/19/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Ashley Morales/directorTIME COMPLETED:
11:01 AM
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On 5/19/23 at 12:00 pm, Licensing Program Analyst's (LPA) Patricia Berry conducted a subsequent case management/incident investigation. LPA were granted access into the facility and met with director. LPA toured facility and took census. No children present during investigation.

A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 4/24/23.

It indicates a teacher was acting inappropriately to the children in the classroom. It was reported a teacher used inappropriate language at a child and threw apples at a child's back.

Facility records were reviewed; 1 staff and 4 children were interviewed. Based on information gathered, LPA could not determine if the incident occurred at this time due to conflicting information.

An exit interview was conducted with director and a copy of this report, appeal rights, and notice of site visit was provided to facility staff.

Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2023
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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