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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313605611
Report Date: 02/14/2024
Date Signed: 02/14/2024 11:39:47 AM

Document Has Been Signed on 02/14/2024 11:39 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KINDERCARE LEARNING CENTER - SIERRA COLLEGE (PS)FACILITY NUMBER:
313605611
ADMINISTRATOR:ANDREANA THORNSBERRYFACILITY TYPE:
850
ADDRESS:8765 SIERRA COLLEGE BOULEVARDTELEPHONE:
(916) 789-9898
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 53DATE:
02/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Andreana ThornsberryTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Jeremey McClain met with facility representative Andreana Thornsberry for an unannounced Case Management Inspection regarding an Unusual Incident Report.

Upon arrival, LPA observed 53 children, supervised by five staff members.

LPA received an Unusual Incident Report via email on 02/07/2024 that on 02/06/2024, Child 1 tripped over another child’s foot and hit their nose on a metal latch attached to the shelf. Child #1’s nose was split and began to bleed. Pressure was applied immediately, and Child #1 was transported to the hospital where stiches were applied.

During today’s inspection, LPA interviewed Staff #1 and observed the area where the incident occurred. Facility immediately removed the metal latch from the shelf. LPA observed the entire classroom for potential hazards. LPA gathered photos and an additional report that was given to the child’s parent through a message on the application on the day of the incident.

No Title 22 deficiencies were cited during today’s inspection. LPA conducted an exit interview with licensing representative, Andreana Thornsberry. LPA provided a Notice of Site Visit that shall remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2024
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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