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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401300
Report Date: 12/01/2023
Date Signed: 12/07/2023 08:46:15 AM

Document Has Been Signed on 12/07/2023 08:46 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
073401300
ADMINISTRATOR:COACH, DANYELLEFACILITY TYPE:
850
ADDRESS:1551 BAILEY ROADTELEPHONE:
(925) 682-9560
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 51DATE:
12/01/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:DANYELLE COACHTIME COMPLETED:
04:00 PM
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On 12/1/2023 Licensing Program Analyst (LPA) Tasha Alexander met with Director Danyell Coach for an Unannounced Required 1-Year Inspection. During the inspection were fifty-one (51) preschool age children and eight (8) preschool staff were present. There are three preschool classrooms (Room 5, Room 6, Room 7) were toured for a health and safety inspection. The facility operates from 6:00am – 6:00pm, Monday – Friday. The facility also holds a license for infants, Facility #073401301 and school age, Facility #073406630 as well.

The facility has ample age appropriate materials in the classrooms that were observed to be clean and in good condition. All toxins, cleaning products, medications and hazardous materials were observed to be in inaccessible areas. There is at least one (1) fully stocked first-aid kit on site. There are carbon monoxide detectors, smoke detectors and multiple fully charged fire extinguishers as well. All sleeping cots are free from defects, properly maintained and stored. All napping equipment is clean and properly stored. All children’s bathrooms are clean, in proper working order, and well maintained. The facility does not store medications at this time.

The outside area is clean, free from defects with ample age-appropriate materials for the children. The play structure is anchored into the ground and properly maintained. The slides are sturdy and cushioned underneath. There are storage sheds that are locked and inaccessible to the children in care. There is also plenty of shade for the children. LPA did not observe any harmful or unattended bodies of water in or around the facility.

The kitchen is clean, well maintained, and all hazards are in inaccessible areas. All children have access to clean drinking water in and outside of the classrooms. The facility provides breakfast, lunch and snacks. All food provided by the facility is properly stored and labeled.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2023
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401300
VISIT DATE: 12/01/2023
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The facility is operating within their licensed capacity and is in ratio in all classrooms. All staff have obtained a criminal record clearance, or transfer. All required postings are made visible in the main hallway of the facility and in front of all classrooms. The fire/disaster drill log is unavailable today. A physical census of the children was taken and cross referenced with the sign-in and out log. All children have been properly signed in by their parent or authorized representative. LPA obtained a sample of the children’s files, a sample of the staff files, and the facility files. All files were complete.

Director was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Personnel Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. Director was reminded that California Law requires all facilities to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.
LPA discussed the safe sleep regulations with Licensee 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 Licensee 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.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
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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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401300
VISIT DATE: 12/01/2023
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This facility does not provide Incidental Medical Services – IMS. 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: http://www.ada.gov/childqanda.htm.

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Danyell Coach .

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 12/07/2023 08:46 AM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 12/01/2023 at 03:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401300

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. THE FIRE/DISASTER DRILL LOG IS NOT AVAILABLE TODAY
POC Due Date: 12/15/2023
Plan of Correction
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LICENSEE WILL LOCATE THE FIRE/DISASTER DRILL LOG AND SUBMIT A COPY TO COMMUNITY CARE LICENSING BY 12/15/23
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
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. TODAY THERE SEVERAL STAFF THAT DO NOT HAVE PROOF OF MEASLES, PERTUSSIS AND FLU VACCINE (J. FORNOF, A. FOWLER
POC Due Date: 12/15/2023
Plan of Correction
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LICENSEE WILL HAVE EACH STAFF MEMBER OBTAIN THEIR RECORDS AND SUBMIT A COPY TO COMMUNITY CARE LICENSING BY 12/15/23
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:Loretta Dyson
LICENSING EVALUATOR NAME:Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 12/07/2023 08:46 AM - It Cannot Be Edited


Created By: Tasha Hackett-Alexander On 12/01/2023 at 03:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073401300

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216(l)(1)(B)
Personnel Requirements
(B) A copy of the signed LIC 9052 (11/94) shall be kept in the employee's personnel record.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care. THERE IS ONE STAFF MEMBER THAT DOES NOT HAVE THE SIGNED EMPLOYEE RIGHTS FORM IN FILE.
POC Due Date: 12/15/2023
Plan of Correction
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LICENSEE WILL HAVE THE STAFF MEMBER SIGN THE EMPLOYEE RIGHTS FORM AND SUBMIT A COPY TO COMMUNITY CARE LICENSING BY 12/15/23
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Loretta Dyson
LICENSING EVALUATOR NAME:Tasha Hackett-Alexander
LICENSING EVALUATOR SIGNATURE:
DATE: 12/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/01/2023


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