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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600789
Report Date: 03/02/2021
Date Signed: 03/02/2021 10:46:10 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 LEARNING CENTER - PASEO LADERA, SAPFACILITY NUMBER:
376600789
ADMINISTRATOR:ANA KINGFACILITY TYPE:
840
ADDRESS:1101 PASEO LADERATELEPHONE:
(619) 482-1800
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:28CENSUS: 13DATE:
03/02/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Ana KingTIME COMPLETED:
10:45 AM
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On 03/02/2021 at 9:30am, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced virtual case management inspection via FaceTime due to COVID-19 and met with Director, Ana King. The purpose of the inspection was to follow-up on an incident that occurred at the facility between two (2) school age children on 02/22/2021 at approximately 3:30pm. According to the unusual incident report, there were 16 school age children being supervised by two (2) staff members on the playground at the time of the incident. There were 13 school age children and one (1) staff member at the time of the inspection.

Staff and children were interviewed during the inspection. LPA and director discussed reporting requirements per Title 22 regulation 101212. LPA informed director to submit documentation relevant to the incident. The incident requires further investigation.

No deficiencies issued during today’s inspection. An exit interview was conducted with the director. Director was advised that a copy of the reports and appeal rights will be sent via email and acknowledgement of receipt of the reports is to be received within twenty-four hours.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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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