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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415772
Report Date: 04/09/2024
Date Signed: 04/09/2024 11:42:18 AM


Document Has Been Signed on 04/09/2024 11:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
013415772
ADMINISTRATOR:SCOTT KINSERFACILITY TYPE:
850
ADDRESS:11925 AMADOR VALLEY COURTTELEPHONE:
(925) 875-0400
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:108CENSUS: 62DATE:
04/09/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Director, Kinser Scott TIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jyoti Saini conducted an unannounced inspection related to the Complaint Investigation. In addition to the Director, 62 children, and eight (8) staff members are present today.
During the course of the interview, LPA found an incident brought to the Facility's attention on 04/04/2024, where one of the teachers videotaped C1 and posted it on private social media. The teacher in question was put on administrative leave effective the same day for pending investigation, and on 04/08/2024, the Facility determined to separate the employment. LPA obtained the termination letter during the inspection.

It concludes that the Facility was aware of the incident but failed to self-report it to the Community Care Licensing Division ( CCLD), which is a violation of Section Reporting Requirements 101212 (d)

Please see LIC 809 D for Type B deficiency.

Appeal rights were given.

A notice of site visit was posted and must remain posted for a period of 30 days.

An exit interview was conducted with Director Scott Kinser.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
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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Document Has Been Signed on 04/09/2024 11:42 AM - 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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612


FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 013415772

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/19/2024
Section Cited
CCR
101212(d)

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101212 Reporting Requirements (D)Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be......following the occurrence of such event.
This requirement is not met, as evidenced by:

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The Facility shall watch the "Child Care Reporting Requirements" at www.ccld.childcarevideos.org and submit a written statement explaining when and how an event should be reported to the Community Care Licensing Division(CCLD) by the POC date.
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Based on interview and record review, the licensee did not comply with the section cited above as the facility did not report an usual incident to the CCLD in timely manners which poses a potential risk to the health, safety, and personal rights of the children in care.
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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: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: 510-298-7052
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
LIC809 (FAS) - (06/04)
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