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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700582
Report Date: 02/01/2023
Date Signed: 02/01/2023 02:31:34 PM


Document Has Been Signed on 02/01/2023 02:31 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 LEARNING CENTER - INFANTFACILITY NUMBER:
376700582
ADMINISTRATOR:CELIDA BANUELOSFACILITY TYPE:
830
ADDRESS:10623 TREENA STREETTELEPHONE:
(858) 271-4700
CITY:SAN DIEGOSTATE: CAZIP CODE:
92131
CAPACITY:45CENSUS: 35DATE:
02/01/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:41 PM
MET WITH:Celida BanuelosTIME COMPLETED:
02:40 PM
NARRATIVE
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On 02/01/2023 at 1:41pm., Licensing Program Analyst (LPA), conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of lead detected in the facility water fixture. LPA met with director, Celida Banuelos. The purpose of the inspection was explained, and facility was toured. There were 35 children in care at time of inspection.
LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, which requires the testing of water for lead in Child Care Centers (CCCs) with facility director during the inspection. Per AB 2370, all CCCs that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every five years after the date of the first testing. LPA obtained copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), and Facility Sketch (LIC999), on November 29, 2022. On December 15, 2022, the Department received notification from the State Water Resources Control Board (SWRCB), Division of Drinking Water (DDW) of an ALE at the facility. The SWRCB report indicated the facility was inspected and samples were collected on October 10, 2022. The outlet/fixture reported with 5.5 ppb or greater lead exceedance level is as follows:

K – Drinking Fountain located at the outside playground.

Director stated water fountain K located at the outside playground has not been in operation since March 2019 due to COVID-19. Director stated that the water for fountain K was removed during COVID. Facility replaced a new drinking water faucet after the lead testing result. Facility has been flushing the drinking fountain as the facility is planning to get the faucet retest. The drinking fountain faucet has been covered with a bag and there is a sign posted reflecting, “Do Not Drink", to ensure the fountain is inaccessible to the children in care.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2023
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 3


Document Has Been Signed on 02/01/2023 02:31 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 LEARNING CENTER - INFANT
FACILITY NUMBER: 376700582

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/02/2023
Section Cited

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California Lead Action Level at Child Care Centers. (b) Testing results with...readings of 5.5 ppb or greater..., before comparing to the Action Level. (1) 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 the water fountain has been covered and a do not drink signage has been placed on the water fountain. There is a zip lock bag with tape placed on the fountain to prevent children from drinking the water.
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Based on record review, the facility did not comply with the directive above, as one out of three drinking or food prep outlets tested with an Action Level Exceedance (ALE). Facility has not been using the outdoor drinking fountain since March 2019 due to COVID. This poses a potential Health and Safety risk to children in care.
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Facility has replaced the water fixture and has been flushing the drinking fountain. Facility is awaiting for the water tester to return to test the new drinking fountain at the playground.

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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: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:
DATE: 02/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/01/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3


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 LEARNING CENTER - INFANT
FACILITY NUMBER: 376700582
VISIT DATE: 02/01/2023
NARRATIVE
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Grant funding will be available for testing and remediation of lead to the Child Care Centers that qualify. To make a determination of eligibility, refer to PIN 21-04-CCP. For Lead Testing and Prevention Information, including additional resources please visit https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information.

See LIC809D for citation issue.

Exit interview conducted and report was reviewed with the Director, Celida Banuelos. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023
LIC809 (FAS) - (06/04)
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