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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001835
Report Date: 12/11/2023
Date Signed: 12/11/2023 04:35:32 PM


Document Has Been Signed on 12/11/2023 04:35 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:
483001835
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
850
ADDRESS:1611 WOOD CREEK DRIVETELEPHONE:
(707) 426-2275
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:86CENSUS: 22DATE:
12/11/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:28 PM
MET WITH:Wendy CertezaTIME COMPLETED:
02:29 PM
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On 12/11/2023, Licensing Program Analysts (LPA), Selena Mariani made an unannounced Case Management visit and met with Director (D1) Wendy Certeza in response to a self reported, lack of supervision Unusual Incident Report (UIR) submitted on 12/7/2023. UIR was regarding child being unsupervised for approximately 1 minutes located in the classroom.

During today's inspection, LPA toured the facility inside and out and observed 22 napping children being supervised by 1 staff member. LPA conducted interviews with D1, Assistant Director (D2) and Staff 1 (S1). D1 stated a child was left behind in a classroom unattended. The child was immediately found and let outside and did not appear to be upset. D1 stated the authorized representatives of the child was notified and was understanding of the incident. D1 stated the incident was addressed with staff involved, reviewing policies and procedure to enure no child is left unattended without a staff member. Staff interview corroborated D1's Statement.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director, Wendy Certeza

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Selena MarianiTELEPHONE: (916) 605-8974
LICENSING EVALUATOR SIGNATURE:
DATE: 12/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/11/2023
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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