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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313604889
Report Date: 06/21/2022
Date Signed: 06/21/2022 03:10:53 PM

Document Has Been Signed on 06/21/2022 03:10 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - FOOTHILLS (PRESCHOOL)FACILITY NUMBER:
313604889
ADMINISTRATOR:LUEDLOFF, CATIEFACILITY TYPE:
850
ADDRESS:5141 FOOTHILLS BLVD.TELEPHONE:
(916) 772-5252
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 106TOTAL ENROLLED CHILDREN: 106CENSUS: 57DATE:
06/21/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Catie Luedloff - Director and
Lynda Carr - Assistant Director		TIME COMPLETED:
04:00 PM
NARRATIVE
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An unannounced case management inspection was conducted today by Licensing Program Analyst Owens. LPA met with Director, Catie Luedloff and Assistant Director Lynda Carr. Present at time of inspection were 57 preschool children with 6 staff.

The purpose of the inspection is to address an Unusual Incident Reports (UIR) received by the facility. The incident occurred on June 17, 2022

See 809 - D
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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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Document Has Been Signed on 06/21/2022 03:10 PM - It Cannot Be Edited


Created By: Katrina Owens On 06/21/2022 at 02:32 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - FOOTHILLS (PRESCHOOL)
FACILITY NUMBER: 313604889

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/22/2022
Section Cited
CCR
101223(a)(2)

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PERSONAL RIGHTS:
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The staff noticed the child was given the wrong bottle and stopped feeding child immediately, corrected action and notified management.
Facility self reported incident to licensing. Parent was notified and
staff training was given.
Deficiency cleared.
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This requirement was not met by a child in the infant room was feed the wrong bottle by a staff, the child drank an oz of the wrong milk.
This is a potential risk to a child.
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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: 06/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/21/2022


LIC809 (FAS) - (06/04)
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