364840920-7-12-2021-09-CC-DHOE-C4USM5-20210712135924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364840920
Report Date: 06/24/2021
Date Signed: 07/12/2021 01:59:52 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 CENTER		FACILITY NUMBER:	364840920
ADMINISTRATOR:	BIERMAN, TRACY		FACILITY TYPE:	840
ADDRESS:	33788 YUCAIPA BLVD		TELEPHONE:	(909) 797-4713
CITY:	YUCAIPA	STATE: CA	ZIP CODE:	92399
CAPACITY:	36	CENSUS: 20	DATE:	06/24/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Director Tracy Bierman		TIME COMPLETED:	07:30 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 06/24/2021 at 03:15pm, Licensing Program Analysts (LPAs) Destinee Hogue and Laura Mejorado arrived at the facility to conduct a required annual inspection, as part of a compliance review. LPAs toured the facility, inside and out, records were reviewed, and the following was observed and discussed with Director Tracy Bierman: A review of the staff records and a sampling children's records were conducted as part of this evaluation. · The licensee is asked to update the following documents, if applicable, and submit to licensing within 30 days: 1. LIC 500 Personnel Report (updated LIC500 needed) 2. LIC 610 Emergency & Disaster Plan (updated LIC610A needed) 3. Parent Handbook/Program Curriculum/Admission policies and procedures/fee schedule (only if changes have been made) 4. LIC 309 Administrative Organization (only if changes have been made) 5. LIC 308 Designation of Administrative Responsibility (only if changes have been made) · The following items have been posted and are updated where necessary: - License - Emergency Disaster Plan (LIC610) and Earthquake Preparedness Checklist (LIC9148) - Parent’s Rights Poster (PUB393) - Personal Rights (LIC613A) - Child Car Seat Law - Menu

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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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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: 364840920
	VISIT DATE: 06/24/2021

NARRATIVE

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· ZERO TOLERANCE - There are no bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· ZERO TOLERANCE - No weapons stored at the facility
· Hazards are stored where inaccessible to children which include: disinfectants, cleaning solutions and other items that are dangerous to children.
· Poisons and toxins are locked
· Medications are stored where inaccessible to children
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· The surface of the outdoor activity space is free of hazards. LPA observed rubber playground cushioning surrounding the surface of the outdoor playground.
· All toilets, handwashing, and bathing facilities are in safe and operating condition, at this time.
· All floors were observed to be clean and free from hazards
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were on and in good repair, at this time.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall.
· The Licensee shall ensure the facility is free of flies, other insects and rodents.
· Appropriate carbon monoxide detector is present and was tested by the Director during this inspection.
· Director understands the child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
· ZERO TOLERANCE - LPAs were granted access inside the facility.
· ZERO TOLERANCE - The facility is operating within the terms of the license.
· A review of staff records on 06/24/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364840920
	VISIT DATE: 06/24/2021

NARRATIVE

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· A Staff member is present with current Pediatric CPR/First Aid which expires on 07/2022
· Opening and closing staff member’s CPR/First Aid expires on 07/2022
· Licensee understand the name of the child care center director or fully qualified teacher(s) designated to act in the director's absence shall be reported to the Department within 10 days of a change.
· Sign in/Sign out record was reviewed and meets regulation requirements
· All personnel, including the Licensee, Administrator and Volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.
· Personnel that pose a threat to the health and safety of children shall be relieved of their duties.
· All personnel shall be given on-the-job training…or shall have related experience that demonstrates knowledge of and skill in…housekeeping and sanitation principles, including universal health precautions.
· ZERO TOLERANCE - Appropriate supervision was provided during this inspection
· Ratios were met during this inspection
· Licensee shall ensure that each child is accorded a safe, healthful and comfortable accommodations, furnishings and equipment to meet the child's needs.
· The Licensee is responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
· The facility is equipped to isolate and care for any child who becomes ill during the day. The Director's office is used to isolate and care for an ill child.
· Each child’s file contains the required identification and emergency information and medical assessment.
· Menus shall be posted at least one week in advance in a place visible by the child’s authorized
· Each Staff’s files contain the required health screening as specified in section 101216(g)
· AB1207 Mandated Child Abuse Reporter training not on file. Staff #1 completed training in either January or April 2019, and Staff #2 was hired on 04/30/2021 and shall complete the mandated training within 90 days of hired date.
· Review of staff records contains proof staff are immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or can write a statement denying the influenza vaccination
· Classrooms are clean and free of hazards
· This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 364840920
	VISIT DATE: 06/24/2021

NARRATIVE

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· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

· The Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200

· Access to forms & Regulations for a Child Care Center are online at www.cdss.ca.gov.

An exit interview was conducted and during the interview, Director, Tracy Bierman confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS. Appeal rights were provided and discussed. This report must be available for review, upon request, for the next 3 years.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC809 (FAS) - (06/04)

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