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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493003397
Report Date: 03/08/2024
Date Signed: 03/08/2024 01:22:55 PM


Document Has Been Signed on 03/08/2024 01:22 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
493003397
ADMINISTRATOR:MELISSA TERHUNEFACILITY TYPE:
830
ADDRESS:1485 N. MC DOWELL BOULEVARDTELEPHONE:
(707) 794-0211
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY:44CENSUS: 10DATE:
03/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Anais Heim, Assistant DirectorTIME COMPLETED:
01:09 PM
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 An unannounced case management- Plan of Correction (POC) visit was made to the facility today by Licensing Program Analyst (LPA) Y.Yang to verify compliance with the POC that the facility submitted on 02/14/24. The facility was cited on 02/01/24 due to facility utilizing staff members that did not meet the education qualifications required to work in the capacity of a teacher in the infant classroom(s).

During today's visit, the LPA met with the facility's assistant director Anais Heim and toured the infant classroom. There were 10 infants present today being supervised by four staff members. The facility was operating in compliance with Title 22 Regulations. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the assistant director, Anais Heim. 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: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
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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