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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364809073
Report Date: 11/18/2021
Date Signed: 11/18/2021 01:53:51 PM

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:
364809073
ADMINISTRATOR:MORALES, ASHLEYFACILITY TYPE:
840
ADDRESS:16149 FOOTHILL BOULEVARDTELEPHONE:
(909) 823-2323
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY:27CENSUS: 0DATE:
11/18/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Jessica Salvador-Rivera/DirectorTIME COMPLETED:
02:19 PM
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On 11/18/2021 at 1:20 pm, Licensing Program Analyst (LPA) Patricia Berry conducted subsequent a case management incident investigation to conclude investigation. LPA was granted access into the facility, and met with director. LPA toured facility; however, there were no school-age children present during the visit.

Regarding a Unusual Incident Report, self reported by director to Community Care Licensing on 10/25/2021, director stated on 10/25 a parent informed her a few months back her child was assaulted by the child's peers. Director stated the child disenrolled on 10/1/21. Director stated, the parent recently brought the issue to her attention.

LPA conducted interviews with staff and children. LPA made attempts to contact parent. Staff stated there was one incident with the child and peers; however, staff stated the children were talked to and there was never another issue. Children stated they never said anything to the child. Children stated they liked the child and wished the child was back at school.


Based on information obtained LPA has determined at this time there has been no violation of Tilte 22 regulations.



Exit interview conducted with director, report, Notice of Sit Visit and Appeal Right provided to the director.


LPA observed director post Notice of Site Visit.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 782-4952
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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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