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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270403
Report Date: 07/10/2023
Date Signed: 07/10/2023 04:38:15 PM

Document Has Been Signed on 07/10/2023 04:38 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:
304270403
ADMINISTRATOR:PORTER, LYNNFACILITY TYPE:
850
ADDRESS:2515 WEST SUNFLOWERTELEPHONE:
(714) 540-4750
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY: 116TOTAL ENROLLED CHILDREN: 116CENSUS: 42DATE:
07/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Lynn Porter - DirectorTIME COMPLETED:
04:45 PM
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Licensing Program Analyst (LPAs) Odom and Navar conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 7/7/2023. LPAs met with Director Lynn Porter. LPA observed 42 preschool age children and 5 staff members. 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 7/7/2023 an self-reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported that on 6/26/23, family member called the childcare facility to inform them that Child #1 (C1) was no longer going to attend the childcare. Family member did not provide an explanation until 7/5/23 when Staff #2 (S2) called the family member requesting for a reason why C1 was no longer going to attend the childcare. Family member disclosed that C1 had gone into the home pool alone in the evening without supervision and C1 had drown. C1 was taken off life support on 6/25/23. During today’s visit, LPA obtained an updated copy of the children’s roster, C1's file, sign in and out and interviewed director. Due to insufficient information available at this time, the reported incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Director Lynn Porter 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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2023
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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