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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600310
Report Date: 04/04/2023
Date Signed: 04/04/2023 02:50:06 PM


Document Has Been Signed on 04/04/2023 02:50 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:KINDERCARE ROTHGARD - PRESCHOOLFACILITY NUMBER:
376600310
ADMINISTRATOR:CELIA CARRIZOSAFACILITY TYPE:
850
ADDRESS:10130 ROTHGARD ROADTELEPHONE:
(619) 670-6566
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:106CENSUS: 68DATE:
04/04/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Liliana ArredondoTIME COMPLETED:
01:30 PM
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On April 4th, 2023, at 11:30am Licensing Program Analyst (LPA), David Miller, conducted an unannounced Case Management Inspection due to an incident with child #1. On 02/13/2023, the Department received the incident report from the facility for child #1. The facility submitted an Unusual Incident Report via fax to our Agency on 02/13/2023.

During today's case management inspection of 04/04/2023, LPA met with the Assistant Director, Liliana Arredondo. Present during today's inspection were 16 napping children and one (1) staff in the 2-year old class, 16 napping children and one (1) staff in the 3-year old class, 19 napping children and one (1) staff in the Pre-K class, and 17 napping children and two (2) staff in the TK/school-aged class.

The facility self reported on 2/13/2023 that grandmother to child #1 was upset after observing a staff member pull her grandson by his coat hood; with child #1 falling to the ground. The sheriff department came to investigate the incident on the same day and issued an Event Report - E8354368. The child did not sustain any injuries or bruising from the incident. LPA interviewed the Assistant Director and staff regarding the incident. Due to insufficient information available at this time, the incident requires further review.

No deficiencies issued during today's visit. LPA conducted an exit interview with the Assistant Director. LPA discussed and provided the following to the Assistant Director: LIC809, LIC9213-Notice of Site Visit, and Appeal Rights. LPA informed the Assistant Director the Notice of Site Visit shall be posted for 30 days from today's date.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2023
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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