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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001834
Report Date: 07/17/2024
Date Signed: 07/17/2024 02:37:58 PM


Document Has Been Signed on 07/17/2024 02:37 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: DATE:
07/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Wendy CertezaTIME COMPLETED:
10:04 AM
NARRATIVE
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During an annual inspection for the facility's pre-school license (Facility License #483001835), Licensing Program Analyst observed, at 9:35 AM, children from the infant license co-mingling with children from the pre-school license in the playground outside. Director, Wendy Certeza stated that she believed the preschool license allowed co-mingling with children from the infant license when a vendor was at the facility from a waiver.

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 Director, Wendy Certeza. Appeal Rights were provided.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2024
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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Document Has Been Signed on 07/17/2024 02:37 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: 07/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2024
Section Cited
CCR
101438.2(b)

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(b) Outdoor activity space shall be physically separate from space used by children in the child care center and school-age child care center components.

This requirement is not met as evidenced by:
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Director stated she would submit a written statement attesting to her understanding of the regulations regarding
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Based on observation, at 9:35 AM, children from the infant license were co-mingling with children from the pre-school license in the playground outside which poses a potential health, safety or personal rights risk to persons in care.
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 outdoor activity space for infants and submit it to LPA by email at robert.maciel@dss.ca.gov.

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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: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert MacielTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2024
LIC809 (FAS) - (06/04)
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