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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600310
Report Date: 12/15/2021
Date Signed: 12/15/2021 03:01:49 PM

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: 41DATE:
12/15/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:29 PM
MET WITH:Celia Carrizosa TIME COMPLETED:
03:20 PM
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On 12/15/21 at 2:29 p.m., Licensing Program analyst (LPA), Rajani Goudreau made an unannounced Case Management inspection to follow up on an incident that was self-reported to the department on 12/03/21. Upon arrival, LPA met with the director, Celia Carrizosa and disclosed the purpose of the inspection and proceeded to tour the facility. The following ratios were observed: 41 children with four staff members present. Facility operates Monday through Friday from 6:00 a.m. to 6:00 p.m.

The initial incident follow up was conducted on December 07, 2021. During today's visit LPA attempted to interview a child that was involved in the incident; however, the child wasn’t in care at time of visit.

No deficiencies issued during today's visit. LPA conducted an exit interview with the director. LPA discussed and provided the following to the director: LIC809, LIC9213-Notice of Site Visit, and Appeal Rights. LPA informed the 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: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
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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