<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566204208
Report Date: 09/09/2019
Date Signed: 09/09/2019 12:23:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:KINDERCARE LEARNING CENTER TOFACILITY NUMBER:
566204208
ADMINISTRATOR:LOESSBERG, LISAFACILITY TYPE:
850
ADDRESS:2425 OAKBROOK DR.TELEPHONE:
(805) 492-2495
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91362
CAPACITY:108CENSUS: 70DATE:
09/09/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Lisa LoessbergTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA)'s Michael Avila and Betzayra Cervantes made an unannounced visit for the purpose of conducting a Case Management inspection. LPA Avila met with Director Lisa Loessberg and discussed the nature and purpose of the visit. LPA's toured the facility accompanied by Director Loessberg.

On 8/15/2019, the facility self reported an incident where a child injured his nose and required medical treatment. The incident occurred at/or around 10:20 am where a child (C1) hit his nose on the edge of a small bench outside on the playground. LPA's met with and interviewed the staff teachers (S1) and (S2) were present and observed the incident as it happened. Staff stated they observed the child (C1) throwing wood chips. Staff asked the child to stop throwing wood chips and the child became upset and threw himself face down to the ground striking his nose causing his nose to bleed. Staff immediately applied first-aid to the child while at the same time contacting the child's parent. The parent immediately came to the facility and picked up her child to seek medical attention.

LPA attempted but was unsuccessful in contacting the parent. LPA's reviewed staff and the child's records.

Based on the information obtained from today's unannounced visit, LPA's determined staff provided adequate supervision and took appropriate action. No deficiencies were issued as a result of this inspection.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2019
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 1