304270339-1-19-2023-06-CC-PRIS-CN8RFH-20230119115909

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270339
Report Date: 01/19/2023
Date Signed: 01/19/2023 12:00:57 PM

Document Has Been Signed on 01/19/2023 12:00 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	304270339
ADMINISTRATOR:	STAHL, VANESSA		FACILITY TYPE:	850
ADDRESS:	3223 ASSOCIATED ROAD		TELEPHONE:	(714) 990-6924
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92835
CAPACITY:	106	CENSUS: 53	DATE:	01/19/2023
TYPE OF VISIT:	Case Management - Lead Testing/Exceedance	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Vanessa Stahl, Director		TIME COMPLETED:	09:30 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) Patricia Rivas conducted a case management visit. LPA met with Director, Vanessa Stahl, to discuss the Lead Sampling Testing conducted on 12/03/2022. Director was advised on 01/17/2023 to post the Lead Sample Report . Facility staff had previously provided LPA copies of all documentation requested regarding Lead; LIC 999 Facility Sketch, LIC 9275 and LIC 9276. LPA confirmed that Director had posted the Lead Sample Report in November 2022.
Census was taken Total of 5 Teachers and 53 children observed in Rooms 5, 7, 8 and 9(room 6 was vacant)
A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Facility 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.
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires all licensed Child Care Centers (CCC’s) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every five years after the date of the first test. Community Care Licensing was notified that lead water testing conducted at the facility on 12/03/2022 failed allowable limit for lead. The purpose of today’s visit is to follow up lead testing results of Action Level Exceedance (ALE) on yard fountains(bubblers) Outlets P (ALE 22) and Q!(ALE 14). In lab report Letter U listed result as 14, Letter Q as 22 and P as 4.3, However, there was no Outlet U on sketch that was tested. Entire report is off one line.

Instructions for required lead testing are outlined in PIN 21-21.1-CCP (Supersedes PIN 21-21-CCP) This PIN which contains Written Directives, have the same force and effects as the regulations contained in Title 22 of the California Code of Regulations.

cont. on page 2

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 304270339
	VISIT DATE: 01/19/2023

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
26
27
28
29
30
31
32

page 2
LPA observed outlets P & Q were made inoperable via by a bag and sign and also outlets were turned off..
Director reports children bring their own water, water is also obtained through outlets (drinking fountains) which passed the lead testing.

Based on LPA's observation and interview with Director, Vanessa Stahl the following violation was observed and is being cited in accordance with Written Directives Section 101700.3 (b)(1) California Lead Action Level at Child Care Centers, is being cited on the attached LIC 809D.

An exit interview was conducted with Director Stahl. Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) 01/16) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the Regional Manager to the address listed.

The Notice of Site Visit was given and discussed it must be posted as required by H & S Code Sec. 1596.817. Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.00.

SUPERVISOR'S NAME: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 01/19/2023 12:01 PM - 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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 304270339
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/19/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/20/2023 Section Cited	1 2 3 4 5 6 7	101700.3 (b) Testing results with fractional ppb readings of 0.5 ppb or greater shall be rounded up to the nearest whole number, before comparing to the Action Level. (1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.	1 2 3 4 5 6 7	During visit, LPA confirmed lead results were posted, and lead documents were submitted. Director will remove, replace or repair outlet P& Q since there is no outlet U and will submit plan of correction by 02/20/2023.
	8 9 10 11 12 13 14	This requirement is not met evidenced by record review of the lab report analysis as reported to Dept from Outlets P(ALE22) & Q(ALE14) taken on 12/03/2022. On facility's report Letter U listed result as 14, Letter Q as 22 and P as 4.3, However, there was no Outlet U on sketch that was tested. Entire report is off one line. Results indicated levels of lead in exceedance at 5.6 This poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Rina Lopez	TELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Pat Rivas	TELEPHONE: 714-703-2800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/19/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3