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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270405
Report Date: 02/16/2021
Date Signed: 02/16/2021 02:21:53 PM

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:
304270405
ADMINISTRATOR:LYNN PORTERFACILITY TYPE:
840
ADDRESS:2515 WEST SUNFLOWERTELEPHONE:
(714) 540-4750
CITY:SANTA ANASTATE: CAZIP CODE:
92704
CAPACITY:28CENSUS: 22DATE:
02/16/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Director Lynn Porter TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA’s) Barajas and Odom conducted a case management inspection to the facility to investigate a self reported incident which occurred on 01/21/2021 regarding a child being grabbed by the arm by a staff member and being moved to another classroom.

LPA’s toured the facility and observed an overall census of 22 school age children with 2 staff members Andrea and Coral. 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 or exemptions.

During today's investigation, LPA’s requested children roster LIC 9040, Personnel Report LIC 500 and attendance sheet for day of incident. Staff were not interviewed, and children were distance learning. Due to insufficient information available currently, the above allegations need further investigation. No deficiency observed during today's inspection.

Exit interview was conducted. Report reviewed and discussed. Notice of Site Visit was posted during the visit. 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. 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 at the address listed above.

SUPERVISOR'S NAME: Patricia MaganaTELEPHONE: (714) 743-5149
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 292-8628
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2021
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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