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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270341
Report Date: 05/19/2022
Date Signed: 05/19/2022 06:00:09 PM


Document Has Been Signed on 05/19/2022 06:00 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 CENTERFACILITY NUMBER:
304270341
ADMINISTRATOR:STAHL, VANESSAFACILITY TYPE:
840
ADDRESS:3223 ASSOCIATED ROADTELEPHONE:
(714) 990-6924
CITY:FULLERTONSTATE: CAZIP CODE:
92835
CAPACITY:42CENSUS: 21DATE:
05/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Vanessa Stahl, DirectorTIME COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Stacy Torrence conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 05/11/2022. LPA met with Vanessa Stahl, Director, LPA toured the facility. Census was taken. LPA observed 21 children present, with 3 staff supervising.

A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 05/11/2022 an self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported a child hit their head three times on a large window and shattered the window. Per director, parent was called and took child to emergency room, in which, child received 10 stitches on child’s head.

During today’s visit, LPA Torrence interviewed two staff members. After interviewing the director and staff, LPA discovered the child hit his hand on the window not his head. Per director, when she called the licensing office to report the incident, she told the analyst taking the report that the child hit his hand not head on the window. LPA obtained a copy of the written report and verified it stated “hand” not “head”. Per director and staff, child has behavioral problems and when child is upset, child tend to hurt self not other children. Staff stated she try to notice when child is getting upset to deescalate his emotion before child gets out of control. Staff stated she talks to the child to calm child down and that works. Director stated mom informed her that child is seeing a psychiatrist and a psychologist for the behavioral problems. Director stated child will not be returning to the facility because of the behavioral problems.

During today’s inspection, there were no deficiency cited per California Code of Regulation, Title 22.

Exit interview was conducted. The Notice of Site Visit was posted. Director was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.
SUPERVISOR'S NAME: Thuy HoTELEPHONE: (714) 287-8515
LICENSING EVALUATOR NAME: Stacy TorrenceTELEPHONE: (714) 300-3599
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2022
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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