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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270926
Report Date: 06/12/2024
Date Signed: 06/12/2024 02:23:33 PM

Document Has Been Signed on 06/12/2024 02:23 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 CENTERFACILITY NUMBER:
304270926
ADMINISTRATOR/
DIRECTOR:		STRAND, STEPHANIEFACILITY TYPE:
850
ADDRESS:855 PASEO WESTPARKTELEPHONE:
(949) 262-0260
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 75DATE:
06/12/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:55 AM
MET WITH:Alexandria RamstorfTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Thompson conducted an unannounced case management incident inspection in response to a self-report Unusual Incident dated 5/28/2024. This is a continuation for the visit initiated on 6/7/2024. During todays visit, LPA met with director Alexandria Ramstorf. During todays visit there were 75 preschool age children with 8 staff.

During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 5/31/2024, a self reported Unusual Incident Report (UIR) was filed with the Licensing Office. The facility reported on 5/28/2024, a teacher observed child #1 (C1) with blood on his fingers. The facility reported C1 appeared to have a scab or an old scratch that C1 had picked.

On 6/7/2024, LPA interviewed the parent of C1 via telephone call. The parent stated it was C1 first day in care and that C1 did not have a prior head injury before attending Kindercare. The parent of C1 stated being made aware of the incident during pick up. Parent of C1 provided LPA with pictures of C1 open head wound laceration and an emergency room after visit summary. The after visit summary dated 5/28/2024, reads C1 reason for visit "Lacerations" and diagnosis "Laceration of scalp without foreign body initial encounter." C1 Doctor placed one absorbable stitch in the cut. Parent stated being told by the doctor, the laceration was consistent with a hard fall.

On 6/7/2024, LPA interviewed five staff. All staff stated they were unsure how the incident occurred.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270926
VISIT DATE: 06/12/2024
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Based on the unexplained injury to C1 head, interviews with staff stating they were unsure how the incident occurred, parent interview, pictures of the open wound laceration on C1 head, and doctors after visit summary report, one Type A deficiency is being cited of the California Code of Regulations, Title 22, Division 12 at the time of the visit. California Code of Regulations, Title 22, Division & Chapter 12, is being cited on the attached LIC 9099D for the deficiency sections 101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs (1) No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual observation.

LPA Thompson informed Director Alexandria Ramstorf that this report dated 6/12/2024, document(s) one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Thompson informed the Director Alexandria Ramstorf to provide a copy of this licensing report dated 6/12/2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the Director Alexandria Ramstorf. Notice of site visit was given and must remain posted for 30 days. Failure to comply with the posting requirements shall result in an immediate civil penalty of $100.



Appeal Rights and deficiencies were discussed. The Director was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/12/2024 02:23 PM - It Cannot Be Edited


Created By: Dean Thompson On 06/12/2024 at 01:58 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: 304270926

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs (1) No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual observation. This requirement is not met evidenced by:
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DIrector stated they had one on one meetings regarding active supervision, constantly walking around, and observation.
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Based on the unexplained injury to C1 head, interviews with staff stating they were unsure how the incident occurred, parent interview, pictures of the open wound laceration on C1 head, and doctors after visit summary report. This is an immediate risk to the health and safety 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:Judy Hanson
LICENSING EVALUATOR NAME:Dean Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2024


LIC809 (FAS) - (06/04)
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