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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493001832
Report Date: 08/02/2019
Date Signed: 08/08/2019 09:11:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
493001832
ADMINISTRATOR:WALLS,LAURENFACILITY TYPE:
840
ADDRESS:6150 STATE FARM DRIVETELEPHONE:
(707) 584-0124
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY:24CENSUS: 0DATE:
08/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:34 PM
MET WITH:Kim RodgersTIME COMPLETED:
04:51 PM
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An annual random inspection was made to the facility by Licensing Program Analyst (LPA), Y. Yang. The facility file was reviewed prior to this inspection. A review of the personnel report on 08/02/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. This school age facility is located at a combination center with a preschool and infant license.

During today's inspection, there were no school age children in care. The acting center director informed LPA that the facility currently does not have any school age children enrolled. The acting center director stated that the school age license has been indefinitely suspended by the center. During today's inspection, LPA provided the acting center director with form LIC 9211 "Request for Inactive Child Care License Status" and explained the process of requesting inactive child care license status.The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. The acting center director stated there are no poisons stored on the premises and none were observed. The facility was free of flies, insects and rodents. There is uncontaminated drinking water available to children both indoors in the classroom and outdoors on the play yard. Food prep areas are clean. Food is properly stored and free of contamination. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is rubber cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. The acting center director stated no weapons are stored on site and none were observed. At least one staff member present at the center during the visit possessed current CPR and First Aid certifications.

Continued on LIC 809-C
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 493001832
VISIT DATE: 08/02/2019
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This facility is not providing Incidental Medical Services (IMS) to children. The Department’s IMS policy was discussed with the acting center Director. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices and The Effects of Lead Exposure brochures, were reviewed and discussed with the acting center director. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2