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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 03:16:48 PM

Document Has Been Signed on 06/21/2022 03:16 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 - IncidentUNANNOUNCEDTIME BEGAN:
02:49 PM
MET WITH:Catie Luedloff, Director and
Assistant Director Lynda Carr		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 20, 2022

LPA Owens informed Director, Catie Luedloff, that this report dated June 21, 2022
documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Owens informed the Director, Catie Luedloff to provide a copy of this licensing report dated June 21, 2022 that documents any Type A citation 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

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 03:16 PM - It Cannot Be Edited


Created By: Katrina Owens On 06/21/2022 at 02:55 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 A
06/21/2022
Section Cited
CCR
101223(a)(3)

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PERSONAL RIGHTS:
To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Facility placed staff immediately on suspension pending facility investigation.

Deficiency Cleared.
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This requirement was not met by a staff was observed grabbing a child by the arms/armpits and shook him aggressively while yelling at him on the playground. The child was crying and screaming while the teacher pulled him away by the arm.
This is an immediate risk to a child. Type A citation is given.
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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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