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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804323
Report Date: 02/22/2024
Date Signed: 02/22/2024 02:13:01 PM

Document Has Been Signed on 02/22/2024 02:13 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804323
ADMINISTRATOR:MARGARITA D. GUILLERMOFACILITY TYPE:
850
ADDRESS:23301 OLIVEWOOD PLAZA DRIVETELEPHONE:
(951) 924-1956
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92553
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 80DATE:
02/22/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:49 PM
MET WITH:Director Margarita GuillermoTIME COMPLETED:
02:17 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jesse Gardner conducted an unannounced case management visit to the center. LPA met with Director, informed them of the purpose of the visit and conducted a tour of the facility.

During an investigation of Complaint Control # 10-CC-20240126152021, was reported the center had three positive cases of Respiratory Syncytial Virus (RSV). One case was found on 1/18/24, and two additional cases on 1/24/24, making the RSV cases an outbreak. Record review and staff interview revealed that the facility did not report the outbreak to the Department.

Based on this information the center did not meet Title 22 Reporting Requirements. As a result of information obtained the facility is being issued a Type B citation in reference to not reporting the outbreak.

An exit interview was conducted where a copy of this report was discussed and provided along with copies of the LIC809D, and Appeal Rights.

A Notice of Site visit was given, and the Licensee understands that it must remain posted for 30 days.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Jesse Gardner
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2024
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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Document Has Been Signed on 02/22/2024 02:13 PM - It Cannot Be Edited


Created By: Jesse Gardner On 02/22/2024 at 01:51 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804323

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/29/2024
Section Cited
CCR
101210(D)(1)(e)

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Reporting Requirements
(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event.
(1) Events reported shall include the following:
(E) Epidemic outbreaks.

This requirement was not being met as evidenced by:
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Licensee states that they will provide the Unusual Incident Report (UIR) to CCL and conduct in-service training to all staff on the cited regulation and provide proof of such by POC date.
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Based on record review, and staff interview, the facility did not report to CCL in reference to the outbreak. This is a potential health and safety risk to children in care.
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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:Deborah Mullen
LICENSING EVALUATOR NAME:Jesse Gardner
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024


LIC809 (FAS) - (06/04)
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