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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804286
Report Date: 05/13/2022
Date Signed: 05/13/2022 05:11:22 PM


Document Has Been Signed on 05/13/2022 05:11 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 CENTERFACILITY NUMBER:
364804286
ADMINISTRATOR:AMANDA CARTERFACILITY TYPE:
850
ADDRESS:7221 CHURCH STREETTELEPHONE:
(909) 862-0967
CITY:HIGHLANDSTATE: CAZIP CODE:
92346
CAPACITY:70CENSUS: 28DATE:
05/13/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Amanda CarterTIME COMPLETED:
05:15 PM
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
Licensing Program Analyst (LPA) Diana Brasel arrived on the above noted date and time to conduct a case management visit in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 04/28/2022 and the incident occurred on 04/27/2022.

Facility records were reviewed, interviews conducted and an inspection of the classroom where the incident occurred. Further information will be needed at this time. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

An exit interview was conducted and a copy of this report was provided to director Amanda Carter.

This report must be available for review, upon request, for the next 3 years.
Notice of Site Visit Issued.

SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Diana BraselTELEPHONE: 951-205-9491
LICENSING EVALUATOR SIGNATURE:
DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/13/2022
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 1