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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313604888
Report Date: 11/15/2023
Date Signed: 11/15/2023 12:41:17 PM

Document Has Been Signed on 11/15/2023 12:41 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KINDERCARE LEARNING CENTER - FOOTHILLS (INF)FACILITY NUMBER:
313604888
ADMINISTRATOR:LUEDLOFF, CATIEFACILITY TYPE:
830
ADDRESS:5141 FOOTHILLS BLVDTELEPHONE:
(916) 772-5252
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 18DATE:
11/15/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Elida Ramirez - Assistant DirectorTIME COMPLETED:
12:30 PM
NARRATIVE
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An unannounced case management inspection is conducted today by Licensing Program Analyst Owens. LPA Owens met with Assistant Director Elida Ramirez. LPA Owens observed 13 toddlers with four staff in the Toddler -A classroom and 5 infants with 2 staff in the infant classroom.

The purpose of the inspection is to discuss an incident that occurred on 11/13/2023 and reported to licensing by the Assistant Director, Elida Ramirez, according to Title-22 regulations.

See deficiency on 809-D
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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
Document Has Been Signed on 11/15/2023 12:41 PM - It Cannot Be Edited


Created By: Katrina Owens On 11/15/2023 at 11:30 AM
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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - FOOTHILLS (INF)
FACILITY NUMBER: 313604888

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/15/2023
Section Cited
CCR
101429(a)(1)

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Responsibility for Providing Care and Supervision for Infants :
Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times.
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Assistant Director stated they are replacing the gate latched, they are installing alarms on all gates leading out of the playground. They will be having an all staff meeting to address safety and making sure all gates are
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This requirement is not met as evidence by a child got out of an unlatched infant playground gate to the front of the facility. The child was not supervised for approximately 4 to 5 minutes. This is an immediate risk to a child. Zero Tolerance. Civil Penalty issued.
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closed. She will send LPA a sign in sheet from the all staff meeting on Tuesday, 11/21/2023 6:00 pm to 8:00 pm.
LIC 9224 was given and discuss at time of inspection.

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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:Keven Peters
LICENSING EVALUATOR NAME:Katrina Owens
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2023


LIC809 (FAS) - (06/04)
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