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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270397
Report Date: 08/06/2024
Date Signed: 08/06/2024 12:54:03 PM

Document Has Been Signed on 08/06/2024 12:54 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270397
ADMINISTRATOR/
DIRECTOR:		JASMIN CANALESFACILITY TYPE:
850
ADDRESS:4601 BEACH BLVD.TELEPHONE:
(714) 994-5610
CITY:BUENA PARKSTATE: CAZIP CODE:
90621
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 66DATE:
08/06/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Jasmin Canales, DirectorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Tran conducted a case management inspection to follow up on a
self-report unusual incident report (UIR) that was submitted to Orange County Regional Office on 07/29/2024. It was reported by Sheryl Nishinaka - Assistant Director. According to the the Assistant Director the unusual incident occurred on Friday 07/26/2024 after 5pm, therefore the report was submitted to Licensing office on the Monday 07/29/2024.

The UIR reported that Staff #1 (S1) reported to Assistant Director that Child #1 (C1) was left unattended at 5:02pm in the Pre-K classroom. The child was left in a classroom when Staff #2 (S2) was leaving from shift and transitioning the children from classroom #8 to the Pre-K classroom (classroom #9). Transition happened at 4:57pm, and S2 clocked out and felt the center at 4:59pm. S1 was notified about C1 was left behind in the classroom and retrieved C1 at 5:02pm. C1 was assessed and was unharmed, C1 was in the library area with a book. Management team was informed and C1's parent was contacted regarding the incident.

During today's inspection a tour of the facility was conducted. Observed at the time of visit were 12 preschool children with 1 staff member in classroom #5, 12 preschool children with 1 staff member in classroom #7, 24 preschool children with 2 staff members in classroom #8 and 18 preschool children with 3 staff members in classroom # 9. LPA informed Director Jasmin Canales the purpose of the visit.

A review of staff records on this date, 08/06/2024, indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances.


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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270397
VISIT DATE: 08/06/2024
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(Page 2 of Report)

During today's inspection, staff members were interviewed and records were reviewed. During interviews, three of three interviewed staff confirmed that incident occurred on 07/26/24. At 4:57pm, S2 and Staff #3 (S3) transitioned 8 children from classroom #8 to classroom #9, through the middle door which connects the two classrooms, and a total of 21 preschool children stayed in classroom #9 with S1 and S3, before being picked up by parents. S2 clocked out at 4:59pm and left the facility. At 5:02pm, S1 was notified by Parent #1 (P1) that C1 was left alone in classroom #8. S1 immediately came over to classroom #8 and retrieved C1 to join the rest of the children in classroom #9. Management team and parents of C1 were informed of the incident. S2 was placed on an administrative leave until further notice. During record reviews, it showed that S2 clocked out at 4:59pm to leave the facility. P1, who notified teacher S2 about seeing C1 being alone in the classroom, signed out P1's child from facility at 5pm. The sign-out time matched with the timeline that was reported in the UIR.

Based on LPA’s interviews and record reviews, the following deficiency is observed in accordance with California Code of Regulations, Title 22, Division 12, Section 101229(a)(1) Responsibility for Providing Care and Supervision. The deficiency is being cited on the attached 809D.

If the facility receives a Type 'A' violation the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days. The licensee is to keep Acknowledgement Receipt (LIC9224) signed by parents in each child’s file.


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SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2024 12:54 PM - It Cannot Be Edited


Created By: Nguyen K Tran On 08/06/2024 at 12:09 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
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270397

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/23/2024
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Responsibility for Providing Care and Supervision (a)(1) No child(ren) shall be left without the supervision of a teacher at any time...

This requirement is not met evidenced by:
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Director will conduct a staff meeting to retrain staff on name-to-face procedure and will submit documentation of the retraining to LPA by due date.
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Based on interviews, 3 of 3 interviewed staff confirmed C1 was left alone in classroom #8. This poses an immediate risk to the health, safety and personal rights of children in care.
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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:Martha Malane
LICENSING EVALUATOR NAME:Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:
DATE: 08/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2024


LIC809 (FAS) - (06/04)
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