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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600694
Report Date: 03/29/2023
Date Signed: 03/29/2023 05:22:37 PM


Document Has Been Signed on 03/29/2023 05:22 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:KINDERCARE - CARLSBAD 1648 - INFANTFACILITY NUMBER:
376600694
ADMINISTRATOR:LEONE POWERFACILITY TYPE:
830
ADDRESS:6270 FLYING LEO CARRILLO LANETELEPHONE:
(760) 431-2558
CITY:CARLSBADSTATE: CAZIP CODE:
92009
CAPACITY:34CENSUS: 27DATE:
03/29/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Director, Leone PowerTIME COMPLETED:
03:35 PM
NARRATIVE
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On 3/29/23 at 3:05pm, Licensing Program Analyst (LPA) Saraliz Velando, conducted an unannounced Case Management Inspection for reported Lead Exceedance. LPA met with Director, Leone Power, and toured the faciity. Aso present in the facility were 27 infants and 9 teachers/staff. Facility was within ratio & capacity. Staff members have the required Criminal record clearance and are associated to the facility. LPA interviewed staff, examined the faucet, and inspected the fixture deemed an Action Level Exceedance.

Fixture reported with 5.5 ppb or greater lead exceedance levels was as follows:

• “Z” Drinking Fountain located in the Toddler Room – 18.3 ppb

Licensee’s testing was completed on 12/30/22. Licensee reported that drinking fountain "Z" was removed and capped off on 3/11/23.

See LIC809-D for cited deficiency.

Exit interview was conducted and report was reviewed with the Director, Leone Power. A copy of Appeal Rights and Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz VelandoTELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2023
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 03/29/2023 05:22 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
SAN DIEGO NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108


FACILITY NAME: KINDERCARE - CARLSBAD 1648 - INFANT
FACILITY NUMBER: 376600694

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/29/2023
Section Cited

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Written Directives per AB2370: 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 the drinking fountain that failed the testing was removed on 3/11/23 and she submitted a Plan Of Correction to the department on 1/19/23.
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Based on water testing results and interviews, facility tested over the Action Level Exceedance at one drinking fountain in the Toddler Room. This posed 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: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Saraliz VelandoTELEPHONE: 619-767-2221
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2023
LIC809 (FAS) - (06/04)
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