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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401312
Report Date: 11/16/2022
Date Signed: 11/16/2022 12:05:23 PM

Document Has Been Signed on 11/16/2022 12:05 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
073401312
ADMINISTRATOR:ZIMMERMAN, PAULAFACILITY TYPE:
850
ADDRESS:150 EAST LELAND ROADTELEPHONE:
(925) 432-8800
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 94TOTAL ENROLLED CHILDREN: 47CENSUS: 26DATE:
11/16/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Juliana O'daeTIME COMPLETED:
12:05 PM
NARRATIVE
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On 11/16/22 at 9:45 AM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Case Management inspection at Kindercare Learning Center about an unusual incident self reported on 10/19/22. LPA met with Assistant Director Juliana O'dae and explained the purpose of today's inspection. During today's inspection LPA conducted interview and obtained relevant documents from the Center's investigation.

During today visit LPA observed a child running out of the facility. Staff 1 was running behind day care child but child was able to exit out of the front entrance. The facility will be cited Type-A for Responsibility for Providing Care and Supervision.

Due to the issuance of Type A, this report has to be provided to all parents of currently and future enrolled over next 12 months. A copy of LIC9224 Statement Acknowledging Receipt of Licensing Reports to be signed by parent and kept in child file.

The following deficiency were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22. 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 Juliana O'dae.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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 11/16/2022 12:05 PM - It Cannot Be Edited


Created By: Michelle Sutton On 11/16/2022 at 11:21 AM
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: 073401312

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2022
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision[..]) No child(ren) shall be left [..] Supervision shall include visual observation. This requirement is not
met as evidence by
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By 11/17/22 Facility agreed to submit a written statement understanding the reguation cited and a plan on how facility will ensure full supervision at all times.
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Based on observation LPA observed a child running out of the facility during inspection. This is an immediate risk to Health and Safety or Personal Rights risk to persons in care.
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By December an all staff meeting/training will be held and a video on Supervision on CCLD website will be reviewed by all. Facility will submit proof of staff meeting.

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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Michelle Sutton
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022


LIC809 (FAS) - (06/04)
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