304270687-7-18-2023-06-CC-MMAK-CTURAE-20230718125100

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270687
Report Date: 07/18/2023
Date Signed: 07/18/2023 12:51:03 PM

Document Has Been Signed on 07/18/2023 12:51 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	304270687
ADMINISTRATOR:	STEVENS, KELSEY		FACILITY TYPE:	840
ADDRESS:	25189 BEACON HILL WAY		TELEPHONE:	(949) 240-4004
CITY:	LAGUNA NIGUEL	STATE: CA	ZIP CODE:	92677
CAPACITY:	14	CENSUS: 12	DATE:	07/18/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Director		TIME COMPLETED:	11:30 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Page 1 of 2 Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted a case management inspection of the facility for the purpose of increasing the capacity by adding an unused school age room (Room # 6) to their existing capacity. LPA met with Director, Kelsey Stevens. LPA was given a tour of the facility by the Director. Currently the facility is licensed for 14 school age children ages 4.9 years to 12 years old in one room only (Classroom # 5). LPA observed there were a total of two staff with 12 school age children in classroom # 6. The facility representative, Kelsey Stevens was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated. The facility has requested to provide care and supervision to 28 school age children ages attending TK to 12 years old in classrooms # 5 and 6, Monday to Friday from 6:30 am to 6:30 pm and one Friday per month extended to 10:00 pm. The children are dropped off, signed in and out electronically. They entered the facility through the entrance of the building leading to rooms. The staff sign children in on times they pick them up from school. The facility has met all the posting requirements. The indoor activity space measurement for the current requested capacity is as follows: Room # 5 is: 496.07 square feet. Room # 6 is: 551.48 square feet. Total indoor activity space measurement is: 1047.55 square feet divided by 35 = 29.93 (30 children). Continued on page 2

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 304270687
	VISIT DATE: 07/18/2023

NARRATIVE

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Total outdoor activity space measurement is: 5302.44 square feet divided by 75 = 70.70 (71 children). Shade is provided by large canape.
Total of toilets: 3 X 15 = 45 children
Total of sinks: 6 X 15 = 90 children
The facility is equipped with carbon monoxide detector. The classrooms have age appropriate toys and equipment. Director's file was reviewed. The file is complete and she is current on CPR and 1st aide, and Mandated Reporter. Orange county Fire authority has approved 28 school age children in rooms 3 and 6. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important license related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.
The facility representative was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
A notice of site visit was given to Director, Kelsey Stevens and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Based on today’s indoor and outdoor measurements, the sinks and toilets availability, the request of the facility for increasing to 28 school age children will be final reviewed and discussed with management in the Regional Office. The facility will be notified if any additional information is required.

Exit interview conducted and report was reviewed with the director, Kelsey Stevens.
End of Report.

SUPERVISOR'S NAME: Thuy Ho	TELEPHONE: (714) 703-2741
LICENSING EVALUATOR NAME: Mahnaz Malek	TELEPHONE: (714) 292-9851
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

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