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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334804334
Report Date: 11/08/2024
Date Signed: 11/08/2024 03:07:23 PM

Document Has Been Signed on 11/08/2024 03:07 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 CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804334
ADMINISTRATOR/
DIRECTOR:		BRANDIE RUBALCABAFACILITY TYPE:
830
ADDRESS:5445 CANYON CREST DRIVETELEPHONE:
(951) 683-1626
CITY:RIVERSIDESTATE: CAZIP CODE:
92507
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
11/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Brandie RubalcabaTIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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On 11/08/2024 at 11:45 AM, Licensing Program Analyst (LPA) Tiffanie Diep met with Director Brandie Rubalcaba for the purpose of an unannounced case management inspection to follow up on an Unusual Incident Report (UIR) submitted to the Department on 10/22/2024. The incident was reported by the facility within the required timeframe. Director guided LPA on a tour of the facility, and LPA observed six staff supervising 20 children.

All individuals subject to a criminal record review have obtained a criminal record clearance. Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Continues on LIC 809-C
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804334
VISIT DATE: 11/08/2024
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Continued from LIC 809 (Page 2)

LPA made observations at the facility and conducted interviews with staff during today's visit. Information obtained revealed a child (C1) sustained an injury while playing in the infant classroom. Interviews conducted disclosed C1 was playing in an area of the classroom with a wall mirror and a horizontal wooden handrail when they bumped their mouth onto one of the mirror screws. During the inspection, LPA observed metal rings surrounding each screw with all screws tightly sealed into the wall. Interviews conducted disclosed that staff immediately attended to C1 and contacted all relevant parties in a timely manner. Information obtained revealed medical professionals determined C1’s injury was not of major concern. It was also revealed that C1 has returned to the facility since the incident. Based on observations made at the facility and information obtained during interviews, it is determined there were no violations pertaining to the incident.

There were no deficiencies cited at this time. An exit interview was conducted and report was reviewed with the director, Brandie Rubalcaba. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Ana Noble
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024
LIC809 (FAS) - (06/04)
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