<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001834
Report Date: 07/11/2024
Date Signed: 07/11/2024 04:46:55 PM


Document Has Been Signed on 07/11/2024 04:46 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001834
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
830
ADDRESS:1611 WOOD CREEK DRIVETELEPHONE:
(707) 426-2275
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:36CENSUS: 24DATE:
07/11/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
09:24 AM
MET WITH:Shirin RashidanTIME COMPLETED:
12:55 PM
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
A required inspection was made to the facility by Licensing Program Analyst (LPA), Robert Maciel. LPA met with Facility Representative, Shirin Rashidan. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff have received criminal record and child abuse index clearances or exemptions. Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The facility’s operating hours are 6:30am-6:00pm, Monday-Friday. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. Sign in/out records were reviewed and in compliance. Items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. Facility Representative stated there are no poisons in the facility, and none were observed during this inspection. LPA observed two infants, child 1 (C1) and child 2 (C2), sleeping on their stomachs. LPA observed the toys, floors, desks and other equipment and surfaces are clean, toxic free, safe, and in good condition. There is uncontaminated drinking water available to children indoors and outdoors using water jug and individual drinking cups. The children's bathrooms are in safe and sanitary condition. LPA observed food prep areas are clean. Food is properly stored and refrigerated as needed. There was no contaminated food observed. Garbage cans containing solid waste have tight fitting lids. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the facility. Last emergency drill was conducted on 6/11/24. LPA observed that the inhaler for child 5 (C5) was expired. LPA observed the playground equipment and surface areas were in safe condition. There is rubber cushioning underneath play equipment to absorb falls. There were no bodies of water observed on the site. Facility Representative stated no weapons are stored on site, and none were observed.

Continued on LIC 809-C.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
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 8


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001834
VISIT DATE: 07/11/2024
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
26
27
28
29
30
31
32
During today's inspection, staffing ratios were being met, 24 children were being supervised by 8 staff. The facility was operating within the licensed capacity and ratio requirements. At least one staff member present during the inspection possessed current CPR and First Aid certifications, which expire April 2026. Five children’s records were reviewed at 2:42 pm which revealed that C1 and C2's LIC9227 Individual Infant Sleeping Plans did not indicate that they are able to roll over, C2 and child 4 (C4) did not possess record of physician's reports, C2, C4, and C5 did not possess record of complete immunizations. 10 staff files were reviewed at 12:33 pm which revealed that staff 2, 3, and 6 (S2, S3, S6) did not possess current Mandated Reporter Training Certificates and staff 1 (S1) did not possess proof of completion, with passing grades, of 3 postsecondary semester or equivalent quarter units related to the care of infants or containing instruction specific to infants.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.



LPA discussed the safe sleep regulations with facility Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Continued on LIC809-C.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024
LIC809 (FAS) - (06/04)
Page: 2 of 8
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001834
VISIT DATE: 07/11/2024
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
26
27
28
29
30
31
32
Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. A notice of site visit was given and shall remain posted for 30 days. Exit interview conducted and report was reviewed with the Facility Representative, Shirin Rashidan. Appeal Rights were provided.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024
LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 07/11/2024 04:46 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(B)(3)(a)
Responsibility for Providing Care and Supervision for Infants
(B) Staff shall physically check on sleeping infant(s) every 15 minutes and document the following: (3) Infants up to 12 months of age who are sleeping in a position other than on their back. (a) If the infant’s Individual Infant Sleeping Plan [LIC 9227 (3/20)] does not have Section C completed, staff shall return the infant to their back for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, at 9:40 AM, LPA observed child 1 (C1) and child 2 (C2) sleeping on their stomachs and C1 and C2's LIC9227 Individual Infant Sleeping Plans did not indicate that they are able to roll over which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2024
Plan of Correction
1
2
3
4
Facility representative stated that staff would review the LIC 9227 Individual Infant Sleeping Plan for each infant under 1 years old to verify whether or not they are able to roll over and send a copy of C1 and C2's updated LIC9227 to LPA by email at robert.maciel@dss.ca.gov.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, staff 2, 3, and 6 (S2, S3, S6) did not possess current Mandated Reporter Training Certificates which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2024
Plan of Correction
1
2
3
4
Facility representative stated she would ensure S2, S3, and S6 obtain a current Mandated Reporter Training Certificate and send a copy of each toLPA by email at robert.maciel@dss.ca.gov.
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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
LIC809 (FAS) - (06/04)
Page: 4 of 8


Document Has Been Signed on 07/11/2024 04:46 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(2)
Health-Related Services
(e) In centers where the licensee chooses to handle medications: (2) All prescription and nonprescription medications shall be maintained with the child's name and shall be dated.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the inhaler for child 5 (C5) was expired which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2024
Plan of Correction
1
2
3
4
Facility representative stated that she would request a non-expired inhaler from the parents of C5 and send a picture of the new inhaler to LPA by email at robert.maciel@dss.ca.gov.
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, child 2 (C2) and child 4 (C4) did not possess record of physician's reports which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2024
Plan of Correction
1
2
3
4
Facility representative stated that she would obtain complete physician's reports for C2 and C4 and send a copy to LPA by email at robert.maciel@dss.ca.gov.
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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
LIC809 (FAS) - (06/04)
Page: 5 of 8


Document Has Been Signed on 07/11/2024 04:46 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001834

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/11/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220.1(g)(1)
Immunizations
(g) The licensee shall document each child's immunizations and shall maintain such documentation in the center for as long as the child is enrolled. (1) This requirement includes updating each child's immunization record when the child is due to receive required immunizations after enrollment in the child care center.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, child 2 (C2), child 4 (C4), and child 5 (C5) did not possess record of complete immunizations which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/18/2024
Plan of Correction
1
2
3
4
Facility representative stated that she would obtain complete immunization records for C2, C4, and C5 and send a copy to LPA by email at robert.maciel@dss.ca.gov.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
LIC809 (FAS) - (06/04)
Page: 6 of 8