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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804286
Report Date: 10/13/2022
Date Signed: 10/27/2022 04:11:34 PM


Document Has Been Signed on 10/27/2022 04:11 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: 24DATE:
10/13/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:36 PM
MET WITH:Amanda CarterTIME COMPLETED:
01:45 PM
NARRATIVE
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On this date and time, Licensing Program Analysts (LPAs) Perla Ordones and Laura Mejorado arrived at the facility to conduct an inspection regarding a separate matter. In the course of the inspection LPAs learned that an incident occurred on 09/23/22 that should have been reported to the Riverside Child Care Regional office. The facility failed to meet the reporting requirements per Title 22 regulations.

See LIC809D for cited deficiency of the California Code of Regulations, Title 22.


Exit interview conducted and report was reviewed with Director Amanda Carter.

A notice of site visit was given and must remain posted for 30 days.

A copy of this report must be made available to the public, at the facility site, for 3 years.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2022
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 10/27/2022 04:11 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: 364804286

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/20/2022
Section Cited

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(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department... within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. This requirement is not met as evidenced by:
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Based on record review and Directors admission, an unusual incident report for an incident that occured on 9/23/22 was not reported to CCL, which poses a potential health, safety or personal rights risk to persons in care.
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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 WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura MejoradoTELEPHONE: 951-782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 10/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/13/2022
LIC809 (FAS) - (06/04)
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