<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600650
Report Date: 04/15/2022
Date Signed: 04/15/2022 03:46:56 PM


Document Has Been Signed on 04/15/2022 03:46 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:REBEKAH SITOMPULFACILITY TYPE:
850
ADDRESS:1200 PLUM TREE ROADTELEPHONE:
(760) 435-0001
CITY:CARLSBADSTATE: CAZIP CODE:
92011
CAPACITY:125CENSUS: 54DATE:
04/15/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Director Corrie BarrickTIME COMPLETED:
03:50 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 4/15/2022 @ 2:35 p.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on a self-reported incident that occurred on 4/4/22, wherein a 3 year old child (Child #1) was left unattended in the classroom.

Based on the information obtained during interviews with staff and review of relevant documentation, Staff #1, who had brought Child #1 into the classroom for a change of clothes, did not ensure that Child #1 returned to the class outside before going on a break. Child #1 was found in the classroom approximately 2- 3 minutes after Staff #1 left on her break.

The child was alone in a safe space for a short period of time. This is a potential hazard to children in care and a Type B deficiency will be cited on the accompanying LIC 809D.

Notice of Site Visit was given and will remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 04/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 04/15/2022 03:46 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: 04/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/03/2022
Section Cited

1
2
3
4
5
6
7
Responsibility for Providing Care an Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met as evidenced by:
8
9
10
11
12
13
14
Based on information obtained though interviews and review of documentation, Child #1 was left behind in the classroom, without supervision, for a period of approximately 2-3 minutes before being found by a staff member and taken back outside. This is a potential hazard to children in care.
8
9
10
11
12
13
14
Director states that there will be another staff meeting on May 2nd where transitioning and supervision will be covered again. At that time she will show the CCLD "Supervising Children in Child Care Centers" to the staff from our website. An agenda of the April 5th agenda was provided today and the May 2nd will be provided by May 3rd with the roster.

1
2
3
4
5
6
7

1
2
3
4
5
6
7
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 PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 04/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2