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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600648
Report Date: 03/07/2025
Date Signed: 03/07/2025 11:14:07 AM

Document Has Been Signed on 03/07/2025 11:14 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KINDERCARE - CARLSBAD INFANT CENTERFACILITY NUMBER:
376600648
ADMINISTRATOR/
DIRECTOR:		MICHELLE PEZMANFACILITY TYPE:
830
ADDRESS:1200 PLUM TREE ROADTELEPHONE:
(760) 435-0001
CITY:CARLSBADSTATE: CAZIP CODE:
92011
CAPACITY: 43TOTAL ENROLLED CHILDREN: 32CENSUS: 28DATE:
03/07/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Amanda HernandezTIME VISIT/
INSPECTION COMPLETED:
11:25 AM
NARRATIVE
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On 3/7/25 at 9:30 AM, Licensing Program Analysts (LPAs) Keturah Lane & Hanna Lucas conducted an unannounced case management visit to follow up on an incident that happened on 2/20/25 and was reported to the duty line the same day. The written report was received from the facility on 2/26/25. The incident involved an infant (C1) that received the wrong bottle that was labeled for another child (C2). Upon arrival, LPAs met with Director Amanda "Mandy" Hernandez and toured the facility. LPAs observed a total of 28 infants/toddlers with the following ratios:
  • Infant A (1) - had 7 infants with staff members Areli Torres and Socorro Cervantes
  • Infant B (2) - had 8 infants with staff members Maritza Rosas and Melody Diaz
  • Infant C (3) had 9 toddlers with staff members Ariana Garcia, Morgan Hodges and Miriam Escobar
  • Toddler A had 4 toddlers with staff member Katherine Ryan
  • Toddler B classroom was not in use

All staff were fingerprint cleared and associated to the facility.

During this visit, LPAs reviewed staff records for S2, received an updated LIC500, LIC9040 and documents related to the incident. LPAs also interviewed staff member (S1) and Director. Staff member (S2) was not coming into the office until later in the day. Director stated that she retrained both S1 and S2 regarding bottle feeding. S1 stated that there was a miscommunication regarding whose bottle was in the warmer and the protocol of naming the label aloud to second staff member ("second staff bottle verification") was not followed. Parents of C1 and C2 were both notified of the incident. Director stated she would retrain all staff (both infant and preschool licenses) regarding bottle feeding procedures and protocols on 3/20/25.



Pursuant to Title 22 of the CA Code of Regulations, the following Type B deficiency was cited (refer to LIC 809-D). Exit interview conducted and report was reviewed with Director Amanda Hernandez. Notice of site visit was provided and must remain posted for 30 days.
Tashima DanielTELEPHONE: (619) 767-2242
Keturah LaneTELEPHONE: (619) 629-8435
DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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Document Has Been Signed on 03/07/2025 11:14 AM - 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KINDERCARE - CARLSBAD INFANT CENTER
FACILITY NUMBER: 376600648

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/21/2025
Section Cited
CCR
101223(a)(2)

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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by...
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Director stated she retrained both S1 & S2 on bottle feeding procedures and will have a training for the entire staff on 3/20/25 and will send signed staff agenda to LPA Lane via e-mail by 3/21/25. Staff will follow verification aloud with a 2nd person before providing an infant a bottle.
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Based upon incident report received from facility and staff interviews, S2 gave C1 the wrong bottle and did not follow facility protocols to ensure C1 received the correct bottle with is a potential health, safety and personal rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Tashima DanielTELEPHONE: (619) 767-2242
Keturah LaneTELEPHONE: (619) 629-8435

DATE: 03/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2025

LIC809 (FAS) - (06/04)
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