364804982-1-13-2023-09-CC-RZEN-CN2PEQ-20230113101531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364804982
Report Date: 01/13/2023
Date Signed: 01/13/2023 10:15:35 AM

Document Has Been Signed on 01/13/2023 10:15 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	364804982
ADMINISTRATOR:	JULIE ZONE		FACILITY TYPE:	850
ADDRESS:	13815 PEYTON DR		TELEPHONE:	(909) 464-2255
CITY:	CHINO HILLS	STATE: CA	ZIP CODE:	91709
CAPACITY:	96	CENSUS: 39	DATE:	01/13/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Crystal Reynolds - Director		TIME COMPLETED:	10:30 AM

NARRATIVE

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On 01/13/2023, Licensing Program Analyst (LPA) Rachel Zeron arrived at the facility to conduct a case management inspection in response to the receipt of an unusual incident report (UIR). The UIR was received by the Riverside Child Care Regional Office on 01/10/2023. The UIR explains a child in the preschool program, fell while playing in the classroom and landed on their leg. The following was discussed during this inspection:

On January 10, 2023, during indoor play time a child fell while playing with magnetiles build shapes. LPA interviews. According to the teacher who witnessed the incident, the child was playing with two other children, they were all playing with the magnetiles. Child #1 (C1), knocked the tiles down on the ground. C1 stood up and a tile was under C1's shoe and C1 slipped and fell on C1's leg. The child was wearing rain boots with little traction. The teacher then attempted to pick the child up back on their feet and the child could not put pressure on C1's left leg. Teacher then left C1 on the floor in the original sitting position, called for the Director to assist. The Director called C1's responsible party to have C1 picked up and evaluated. Director received a call from the responsible party later that day, approximately 5:00 pm to report that C1 had broken their left femur and would be put in a cast. C1 is expected to return in 6 weeks.

Based on the information obtained during this visit, there appears to be no violations of Title 22 Regulations at this time.

No deficiencies were cited during this inspection and a copy of this report was provided to Director, Crystal Reynolds. Director understands a copy of this report shall be kept on record for three years and provided to the public upon request.

SUPERVISOR'S NAME: Aaron Ross	TELEPHONE: (951)320-2023
LICENSING EVALUATOR NAME: Rachel Zeron	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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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