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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270403
Report Date: 08/08/2023
Date Signed: 08/08/2023 12:14:05 PM

Document Has Been Signed on 08/08/2023 12:14 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: 67DATE:
08/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Lynn Porter - DirectorTIME COMPLETED:
12:30 PM
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This is a follow up UIR Case Management Inspection from visit dated 07/10/23. A case management inspection was conducted today by Licensing Program Analyst (LPA), Odom who met with the Director, Lynn Porter. A self-report incident by the facility was received by regional office on 07/07/23 which stated 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.

Census was taken today and there was a total of 67 preschool age children with a total of 8 staff. A review of criminal record clearances indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

During the investigation, LPA interviewed 2 staff members and obtained a copy of the roster, sign in sign out sheet for 06/23/23, a copy of child’s file. Police report and death certificate are pending. Through interviews conducted with staff it was disclosed that the incident occurred on the evening of 06/23/23 at the child’s home. S2 spoke with adult #1 (A1) on 06/26/23 over the phone, A1 informed S2 that C1 will no longer attend the childcare center. S2 informed A1 according to childcare policies they need to provide a 2-week notice, A1 disclosed C1 had passed away. S2 stated A1 was very emotional and did not provide additional details. On 07/03/23 S2 attempted to speak with A1 to gather more information about C1’s incident. On 07/05/23 S2 spoke with A1 over the phone, A1 disclosed on 06/23/23 after being picked up from the childcare center Parent #1 (P1) took C1 swimming at the family’s home pool for a few hours, bathed and fed C1. A1 disclosed P1 turned their back for a moment and saw that the sliding door was open and P1 found C1 inside the pool unresponsive. C1 was taken to the hospital and was taken of life support on 06/25/23. Staff never spoke with P1 due to language barrier A1 communicated with the childcare center. Continue to page 2.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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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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: 304270403
VISIT DATE: 08/08/2023
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Statements made by staff the incident did not occur in the childcare center. Reporting requirements were met. Based on LPA observations, interviews conducted, and records/documentation reviewed, there is no evidence to support any violation of Title 22 regulations. No Title 22 deficiencies cited during today's inspection.

Exit interview was conducted. Notice of Site Visit was posted during the visit. 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. Appeal rights provided and explained. The Director was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above.

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC809 (FAS) - (06/04)
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