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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600650
Report Date: 03/02/2023
Date Signed: 03/02/2023 12:16:38 PM


Document Has Been Signed on 03/02/2023 12:16 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 - CARLSBADFACILITY NUMBER:
376600650
ADMINISTRATOR:MELISSA RUIZFACILITY TYPE:
850
ADDRESS:1200 PLUM TREE ROADTELEPHONE:
(760) 435-0001
CITY:CARLSBADSTATE: CAZIP CODE:
92011
CAPACITY:125CENSUS: 60DATE:
03/02/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Director Melissa RuizTIME COMPLETED:
12:25 PM
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On 3/2/2023 @ 12:05 p.m., Licensing Program Analyst (LPA), Joelle Redding, made an unannounced visit to evaluate the facility for a reported lead exceedance.

During this visit, it was clear that the information from the Water Board, the report from the lead testing agency and the facility map are not matching. The facility has made the sinks inaccessible that were identified to them as testing positive in Room 2B and 2C (which has been closed completely for several months). These sinks were used for handwashing. Alternate sinks have been provided.

The facility has reported the discrepancy to the lead testing agency who will be coming out to redo the testing with a current facility map. The results will be reported to Licensing. Should the facility determine that any sink not formerly identified has tested positive, that sink will be made immediately inaccessible.

See LIC 809D for Type B deficiency.

Exit interview conducted and report was reviewed with Director. NOTICE OF SITE VISIT WAS GIVEN AND MUST REMAIN POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023
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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Document Has Been Signed on 03/02/2023 12:16 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KINDERCARE - CARLSBAD
FACILITY NUMBER: 376600650

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/30/2023
Section Cited

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Written Directives: A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement is not met as evidenced by:
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Director stated that they have made those sinks inaccessible and provided alternative handwashing sinks for use. Retesting will be done and the report will be provided to Licensing. Director states that she will make any previously unidentified sink inaccessible should it test positive.
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Based on water testing results and interviews, facility tested over the Action Level Exceedance level on two handwashing sinks in the 2B and 2C rooms. This poses a potential health, safety or 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.
SUPERVISOR'S NAME: Renesha AskewTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 03/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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