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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001828
Report Date: 02/28/2024
Date Signed: 02/28/2024 01:09:49 PM


Document Has Been Signed on 02/28/2024 01:09 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001828
ADMINISTRATOR:HAYMER, MORNENFACILITY TYPE:
850
ADDRESS:581 PEABODY ROADTELEPHONE:
(707) 447-7685
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:75CENSUS: DATE:
02/28/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Brenda HardawayTIME COMPLETED:
09:00 AM
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LPA Ouye arrived unannounced to conduct a case management visit to deliver a civil penalty of $250 for a repeat violation.

During LPA Augustin visit on 12/13/23 the facility was cited for not maintaining the minimum teacher child ratio requirements. The facility was previously cited this same subsection on a prior visit on 06/28/23 which triggered a repeat violation within a 12-month period, resulting in a civil penalty of $250 being assessed for repeat violation of teacher-child ratio requirements of California Code of Regulations (CCR) 101216.3(a)

LPA Ouye will obtain a signed copy of an LIC421FC Civil Penalty Assessment - Failure to Correct and Repeat Violation. A signed copy of the LIC421FC will be left with the facility representative.

No deficiencies cited during this visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn OuyeTELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2024
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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