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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313605611
Report Date: 05/13/2022
Date Signed: 05/13/2022 11:38:23 AM

Document Has Been Signed on 05/13/2022 11:38 AM - 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 - SIERRA COLLEGE (PS)FACILITY NUMBER:
313605611
ADMINISTRATOR:BRANDEBERRY, MELISSAFACILITY TYPE:
850
ADDRESS:8765 SIERRA COLLEGE BLVDTELEPHONE:
(916) 789-9898
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: DATE:
05/13/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Andreanna ThornsberryTIME COMPLETED:
11:40 AM
NARRATIVE
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On May 13th, 2022, at 9:40 am, Licensing Program Analyst (LPA) Jeremey McClain met with Director Andreana Thornsberry for an unannounced Case Management Inspection regarding an Unusual Incident Reported received via fax and email on May 11th, 2022.

LPA observed care and supervision of 41 preschool children by five staff in three separate room.

It was reported that on May 10th, 2022, a child was absent from the facility and found in the playground of neighboring facility, Child Time Children’s Learning Center. Staff #1 and Staff #2 became aware of the that Child #1 was absent class while transitioning children inside from the playground. Staff immediately notified management who then searched for the child inside and outside of the building. 911 was called and the fire department found the child at the neighboring facility approximately 15 minutes after the staff realized the child was missing. It was determined that the child made it to the neighboring after proceeding through the walkway and climbing past two chain link fences, and an iron rod fence that divides the two facilities. The child did not sustain any injuries. Parents were notified.

Type A citation
LPA Mcclain informed Director Andreana Thornsberry that this report dated May 13th, 2022 documents a Type A citation which shall be posted for 30 consecutive days as there are immediate risk to the health and safety of children in care.
Also, LPA Mcclain informed Director Andreana Thornsberry to provide a copy of this licensing report dated May 13th, 2022 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. Report continued on the following page.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: KINDERCARE LEARNING CENTER - SIERRA COLLEGE (PS)
FACILITY NUMBER: 313605611
VISIT DATE: 05/13/2022
NARRATIVE
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An immediate Civil Penalty of $500 will be assessed.

Posting Requirements
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA reviewed this report with the director and conducted an exit interview. LPA provided Appeal Rights, and a Notice of Site Visit that must remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
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Document Has Been Signed on 05/13/2022 11:38 AM - It Cannot Be Edited


Created By: Jeremey McClain On 05/13/2022 at 10:48 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - SIERRA COLLEGE (PS)
FACILITY NUMBER: 313605611

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2022
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision.(1)No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by: Facility self-reported that
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All families were notified of the incident as well as the district leader. Facility has began the process of replacing the iron rod fence with a privacy fence that is not climbable. Facility will also add additional fencing to the chain link fence that will also make it unclimbable. Director stated that the new fencing should be completed as soon as possible and a work
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on May 10, 2022, Child #1 was absent from the facility for approximatley 15 minutes, and found by the fire department at the playground of a neighboring facility. This is an immediate risk to the health and safty of children in care.
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order has been placed. Director has plan of action to retrain staff on supervision and playground

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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:Jeremey McClain
LICENSING EVALUATOR SIGNATURE:
DATE: 05/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/13/2022


LIC809 (FAS) - (06/04)
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