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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270397
Report Date: 04/12/2022
Date Signed: 04/12/2022 04:24:25 PM

Document Has Been Signed on 04/12/2022 04:24 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:
304270397
ADMINISTRATOR:JASMIN CANALESFACILITY TYPE:
850
ADDRESS:4601 BEACH BLVD.TELEPHONE:
(714) 994-5610
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY: 104TOTAL ENROLLED CHILDREN: 104CENSUS: 65DATE:
04/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jasmin Canales, DirectorTIME COMPLETED:
04:30 PM
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On 04/12/2022, Licensing Program Analyst (LPA) Nguyen Tran conducted a case management inspection to follow up on a self-report unusual incident that was submitted to Community Care Licensing Regional Office on 04/07/2022. It was reported by Jasmin Canales, Director that on 04/06/22, at 10:28am, Staff #1 (S1) with 12 preschool children on the playground started transitioning to room # 5 at 10:23 am. She left child #1 (C1) on the playground. Staff #2 (S2), from next door room # 6, opened her door to take her children out at 10:28 am. S2 saw C1 on the play structure on the playground unsupervised. S2 reported to Director who came to the class to check on the class. When Director came to the playground to check on C1. S1 opened her door to look for C1. According to Director, the child must have been unsupervised for 2 minutes.

During today's inspection a tour of the facility was conducted. There were 65 children and 8 staff in 5 different classrooms. A review of staff 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. During today's inspection, LPA inspected location of the incident and interviewed staff members.

Due to insufficient information at this time, more interviews are needed.

Appeal Rights were discussed. The facility director Jasmin Canales was provided a copy of their appeal rights (LIC 9058) 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director.

(End of Report)
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
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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