376600694-5-29-2019-51-CC-JREG-BCMNUK-20190529104627

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600694
Report Date: 05/29/2019
Date Signed: 05/29/2019 10:46:31 AM

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-CARLSBAD 1648-INFANT		FACILITY NUMBER:	376600694
ADMINISTRATOR:	LEONE POWER		FACILITY TYPE:	830
ADDRESS:	6270 FLYING L.C. LANE		TELEPHONE:	(760) 431-2558
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92009
CAPACITY:	34	CENSUS: 24	DATE:	05/29/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Director Leone Power		TIME COMPLETED:	10:50 AM

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	Licensing Program Analyst, Joelle Redding, made an unannounced visit to follow up on two self reported incidents as follows: 5/22/19: Child #1 (16 months) slipped and hit his eye brow on a shelf, sustaining a laceration for which medical attention was sought. 5/23/19: Child #2 (16 months) suffered a seizure in the classroom for which medical attention was sought. LPA interviewed Staff #1 in relation to the incident of 5/22/19. She stated that there were four children with her at the time of the incident. She was approximately 10 to 15 feet away from Child #1, changing a diaper on the changing table. Child #1 was standing by a shelf that was approximtely 18" high when he abruptly fell, bumping this eyebrow area on the edge of the shelf. Staff #1 stated that she had completed the diaper change and responded to Child #1, applying pressure to stop the bleeding and alerting the Director, Leone, who was in the adjoining classroom. Ice was applied while awaiting parent pick up. Parents transported to the doctor where the laceration was sealed with medical glue. Child #1 returned to care on on his next scheduled day. Staff #1 stated that Child #1 had just started walking a few months ago and was still a little wobbly on his feet. LPA interviewed the Director and Staff #2 in relation to the incident of 5/23/19. Child #2 had been acting and eating normally all morning when suddenly, at naptime, he began to seize. Staff #2 stated that she picked him up and alerted the teacher in the next room (Staff #3) who took over as she was unable to leave the classroom due to ratios. Director stated that Staff #3 brought Child #2 to her office where 911 and the child's parents were contacted. Upon initial evaluation, the child had a very slightly elevated temperature of 99.3 which rose a degree before returning to normal by the time they arrived at the hospital. Child #2 was

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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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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 1648-INFANT	FACILITY NUMBER: 376600694
	VISIT DATE: 05/29/2019

NARRATIVE

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evaluated and released. Over the weekend he did spike a higher temperature and experienced two more seizures at home. Further medical evaluation will be done. In the meantime, the facility has put a plan in place for frequent temperature monitoring, avoiding situations which would cause the child to overheat, encouraging water intake and alerting the parent for pick up should he spike a temperature of 99.

In both incidents, ratios were met, supervision was in place, the staff responded appropriately and the facility reported timely. LPA evaluated the shelf in the toddler classroom and determined it to be age appropriate with rounded edges.

No deficiencies are cited.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

LIC809 (FAS) - (06/04)

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