483001835-7-17-2024-01-CC-RMAL-D79TF4-20240717144055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 483001835
Report Date: 07/17/2024
Date Signed: 07/17/2024 02:41:04 PM

Document Has Been Signed on 07/17/2024 02:41 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 CENTER		FACILITY NUMBER:	483001835
ADMINISTRATOR:	WENDY CERTEZA		FACILITY TYPE:	850
ADDRESS:	1611 WOOD CREEK DRIVE		TELEPHONE:	(707) 426-2275
CITY:	FAIRFIELD	STATE: CA	ZIP CODE:	94534
CAPACITY:	86	CENSUS: 28	DATE:	07/17/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Wendy Certeza		TIME COMPLETED:	02:50 PM

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A required inspection was made to the facility by Licensing Program Analyst (LPA), Robert Maciel. LPA met with Director, Wendy Certeza. 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. Direcotrwas 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. Director stated there are no poisons in the facility, and none were observed during this inspection. 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 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. Director stated no weapons are stored on site, and none were observed.

Continued on LIC 809-C.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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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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: 483001835
	VISIT DATE: 07/17/2024

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During today's inspection, staffing ratios were being met, 28 children were

being supervised by 4 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 1:11 pm which revealed that the facility did not possess record of child 2's (C2) immunizations or child 1, 2, and 3's (C1, C2, and C3) physician's report, child 1's (C1) identification and emergency information card was not signed, child 2's (C2) personal rights and parent's rights forms were not signed. 5 staff files were reviewed at 10:52 am which revealed that staff 3, staff 4, and staff 5 (S3, S4, and S5) did not possess current mandated reporter training certificates, S3 did not possess proof of immunization against measles, and the facility did not possess record of S3 and S4's LIC503 Health Screening.

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 Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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

LIC809 (FAS) - (06/04)

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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: 483001835
	VISIT DATE: 07/17/2024

NARRATIVE

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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 Director, Wendy Certeza. Appeal Rights were provided.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/17/2024 02:41 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: 483001835
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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 3, staff 4, and staff 5 (S3, S4, and S5) 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: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would ensure that S3, S4, and S5 obtain current mandated reporter training certificates and send a copy to LPA by email at robert.maciel@dss.ca.gov.

Type B

Section Cited

HSC

1596.7995(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, staff 3 (S3) did not possess proof of immunization against measles which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would ensure that S3 obtain proof of immunization against measles 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 Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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)

Page: 4 of 6

Document Has Been Signed on 07/17/2024 02:41 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: 483001835
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(g)(1)

Personnel Requirements

(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the facility did not possess record of staff 3 and staff 4's (S3 and S4) LIC503 Health Screening which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would obtain the LIC503 Health Screenings for S3 and S4 and send a copy 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, the facility did not possess record of child 1, 2, and 3's (C1, C2, and C3) physician's report which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would obtain C1, C2, and C3's physician's report 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 Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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)

Page: 5 of 6

Document Has Been Signed on 07/17/2024 02:41 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: 483001835
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101220.1(g)

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. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the the facility did not possess record of child 2's (C2) immunizations which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would obtain C2's immunization record and send a copy to LPA by email at robert.maciel@dss.ca.gov.

Type B

Section Cited

CCR

101221(a)

Child's Records

(a) The licensee shall ensure that a separate, complete and current record for each child is maintained 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 1's (C1) identification and emergency information card was not signed and child 2's (C2) personal rights and parent's rights forms were not signed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2024
	Plan of Correction
1 2 3 4	Director stated she would have C1's identification and emergency information card and C2's personal rights and parent's rights forms signed 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 Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Robert Maciel	TELEPHONE: (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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