364830080-11-20-2023-12-CC-KCAY-CXRV8P-20231120151305

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364830080
Report Date: 11/20/2023
Date Signed: 11/20/2023 03:13:23 PM

Document Has Been Signed on 11/20/2023 03:13 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	364830080
ADMINISTRATOR:	BRIANNE HINDMAN		FACILITY TYPE:	850
ADDRESS:	13615 BEAR VALLEY ROAD		TELEPHONE:	(760) 949-8539
CITY:	VICTORVILLE	STATE: CA	ZIP CODE:	92392
CAPACITY:	88	CENSUS: 76	DATE:	11/20/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Jennifer Johnson, Director		TIME COMPLETED:	03:30 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	On November 20, 2023, Licensing Program Analyst (LPAS) Calloway and Ali made an unannounced inspection for the purpose of conducting an Annual/Random inspection. LPAs met with the Site Director who granted access. LPAs toured the facility with the Director and observed seventy-six (76) day care children in active play and seven (7) staff. Capacity is for eighty-eight (88) day care children. Ages two through kindergarten. Teacher/Child ratios are met according to Title 5 of the California Code of Regulations and Title 22 Regulations. The daily hours of operation are from 6:30 AM- 6:30 PM. Children enter through the front entrance of the center. Incidental Medical Services (IMS) were discussed. Physical Plant: Day care is provided in four (4) classrooms Preschool #1, Preschool #2, Discovery Preschool, and Transitional Kindergarten (TK) there were age-appropriate toys, books, furniture, equipment, in good repair. The center has a curriculum learning program and provides activities and meals/snacks. The telephone service was verified. Heating, lighting, and ventilation are adequate. There are cubbies/bins (labeled with photos) for children's belongings. Drinking water is available via water pitcher and disposable cups or water fountain at the sink. There is a fire alarm pull located (near exit door). Sprinkler system inside the ceiling. Fire extinguishers observed on the wall (near exit full/green).

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
	VISIT DATE: 11/20/2023

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Kitchen: observed fully equipped with refrigerator, freezer, 2 ovens, steamer, handwashing sink, and three (3) sinks. The facility provides breakfast, lunch, and one afternoon snack. Food kept inside kitchen storage area. LPAs observed an adequate amount of food and snacks. LPAs observed frozen chicken in the freezer (unlabeled with freezer burn). LPAs recommended removal. Refrigerator/Freezer (operable at normal temperature for food storage). Cleaning solutions and other chemicals are kept in laundry room (locked).
Bathrooms: LPAs inspected and observed two (2) clean bathrooms (2 toilets and 2 sinks). The toilets and sinks are functioning properly and are age appropriate. LPAS observed soap, toilet paper, and paper towels readily available. Locked storage cabinet observed. The staff restroom is in the middle of the hallway.
Outside: The outdoor play equipment was inspected for health, safety, cushioning material, good repair. Equipment is age appropriate. The play area (gated) has concrete and grass. There is an area for rest (canopy). Water is provided via the water fountain. The play area was inspected and found to be free of hazards and inaccessible to bodies of water. Separate playground schedule for infant and preschool children. The jungle gym is anchored.
Others: LPAs observed First Aid Kit backpacks in all classrooms (stocked with manual). Fire Drill/Earthquake log (current) and Roster (current). Sign-in and out sheets were reviewed in the lobby and classrooms (complete, legible, signatures) Care and supervision were evaluated to determine if the basic needs of children are met and appropriate. LPAs observed the parent board consisting of licensing-required postings, LIC 610 is missing. Children's records and staff records were reviewed/documented. LPAs verified there is at least one (1) staff person present with current CPR and First Aid Training (Exp.2/2025). Mandated Reporter training in staff files reviewed (current).

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
	VISIT DATE: 11/20/2023

NARRATIVE

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Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered only with the parent's written permission. The Director administers medication and documents the dosage, date, and time on a log. Medication is brought and taken home by the parent daily. Medication is properly labeled and stored in its original container. There are children in care with IMS needs on this site. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
There is a separate area for isolation and care of ill children in the Learning Adventures Room near the infant classroom.
The following general information was discussed during this inspection:
The Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. The Center does not provide IMS at this time.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
	VISIT DATE: 11/20/2023

NARRATIVE

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Mandated Reporter Training Requirements: §1596.8662 - As of January 1, 2018, childcare providers, administrators, or employees who work in a licensed facility shall complete the mandated reporter training provided according to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
Immunization Requirements: §1596.7995 (a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a daycare center if he or she has not been immunized against influenza, pertussis, mumps, rubella, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
*All Licensing reports are available for review online and are considered public information. Summary: Assembly Bill 2621 added Section 1596.819 to the Health and Safety Code, to require the Department to post certain licensing information for CCCs and FCCHs on its public internet website.
Fingerprint clearances and transfers: Before working or volunteering in a licensed childcare facility, all individuals subject to a criminal record review shall obtain a clearance or criminal record exemption. If a fingerprint clearance has been obtained through the Department, Licensee may request a transfer of a criminal record clearance from one state-licensed facility to another using form LIC 9184
**Each report (documenting a Type A citation) shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). In addition, all parents of currently enrolled children and any newly enrolled child for the following 12 months shall receive a copy of the report documenting a Type A Citation and sign form LIC 9224 acknowledging receipt placed in child’s files.

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
	VISIT DATE: 11/20/2023

NARRATIVE

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Staff is aware of the required forms for children's files and forms that shall be posted after licensure.
**Senate Bill AB 633 - Child Care Facilities: Parent Notification Requirements
Summary: This bill amends Health and Safety Code (HSC) sections 1596.859, 1596.8595, 1596.8895, and 1597.05 to improve the transparency of licensing records and to ensure that parents/guardians using a licensed childcare facility are aware of situations that present health, safety, or personal rights risks for children in care.

Per Title 22 Regulations, there are deficiencies being cited during this inspection. See 809-D pages.

Exit interview conducted with a copy of this report was read, a Notice of Site Visit, and Appeal Rights were provided to Jennifer Johnson, Site Director at the facility. A Notice of Site Visit must remain posted for thirty (30) consecutive days. Failure to maintain posting will result in a $100 Civil Penalty

SUPERVISOR'S NAME: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/20/2023 03:13 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above S4 did not have immunizations for MMR and Tdap in their staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/30/2023
	Plan of Correction
1 2 3 4	Per Director proof of immunizations will be sent to Licensing by POC date of 11/30/23

Type B

Section Cited

CCR

101220(a)

Child's Medical Assessments

(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in four children C2, C10, C11, and C12 did not have their LIC 701 inside their files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/20/2023
	Plan of Correction
1 2 3 4	Per Director proof of LIC 701 will be provided to Licensing by POC date of 12/20/23.

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: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/20/2023 03:13 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101221(b)(8)(C)

Child's Records

(C) A signed consent form for emergency medical treatment unless the child's authorized representative has signed the statement specified in Section 101220(f). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, and record review, the licensee did not comply with the section cited above in two children C7 and C10 did not have the form LIC 627 inside their files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/30/2023
	Plan of Correction
1 2 3 4	Per Director proof will be provided to Licensing by POC date of 11/30/23.

Type B

Section Cited

CCR

101223(b)(1)

Personal Rights

(1) The center shall give each authorized representative a copy of the Personal Rights form (LIC 613A [9/96]). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in one child C7 did not have the LIC 613A form inside their files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/30/2023
	Plan of Correction
1 2 3 4	Per Director proof will be provided to Licensing by the POC date of 11/30/23.

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: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/20/2023 03:13 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364830080
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101212(b)

Reporting Requirements

(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview, record review, the licensee did not comply with the section cited above in S1 did not follow up with the completion of the Director Qualifications which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/30/2023
	Plan of Correction
1 2 3 4	Per Director the information will be provided to Licensing by POC date 11/30/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Claretta Yates	TELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Kuliema Calloway	TELEPHONE: (661) 202-3381
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2023

LIC809 (FAS) - (06/04)

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