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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334809081
Report Date: 07/30/2024
Date Signed: 07/30/2024 02:03:57 PM

Document Has Been Signed on 07/30/2024 02:03 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334809081
ADMINISTRATOR/
DIRECTOR:		TARA MARTINEZFACILITY TYPE:
850
ADDRESS:610 E. NUEVO ROADTELEPHONE:
(951) 943-6476
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 58DATE:
07/30/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:21 PM
MET WITH:Tara Martinez TIME VISIT/
INSPECTION COMPLETED:
02:29 PM
NARRATIVE
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On July 30, 2024, at 1:21 PM, Licensing Program Analyst (LPA) Anastasia Flores, arrived for the purpose of delivering a case management deficiency. During an investigation dated, 7/09/24; control number 10-CC-20240709141128 several confidential interviews disclosed that an uncleared adult(A3), not associated to the CC is utilized as staff when the director and assistant director are too busy. Confidential interviews disclosed that A3 has been seen picking up children from the bus and taking them to their classroom, reading stories to the children in the classroom, where the children are often wanting to climb on A3, and the staff have to prevent the children from attempting to climb all over A3. Confidential interviews revealed that A3 has been seen placing a child (C1) on the shoulders and walking C1 to class with C1 on A3’s shoulders. Records reviewed show that A3 is not associated to the CCC and is allowed to interact with the children in care daily.
Based on interviews and record review, the facility is being cited for Title 22, division 12, chapter 1, article 06; section; 101170(e)(2) Criminal Record Clearance.
A Civil Penalty of $500.00 was assessed for this violation of Title 22 Regulations. See LIC 421BG.
An exit interview was conducted. A copy of this report, 809D, LIC421BG and appeal rights were reviewed and handed to the Director.

The Director was informed that the “Notice of Site Visit” must be posted for 30 consecutive days. Failure to post will result in Civil Penalties of $100.00. The “Notice of Site Visit” must be posted on or adjacent to the door.
If the facility receives a Type A violation, the licensee shall post and provide copies of the report to parents/guardians of the children in care at the facility by the next business day and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Anastasia Flores
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
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 07/30/2024 02:03 PM - It Cannot Be Edited


Created By: Anastasia Flores On 07/30/2024 at 01:04 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: 334809081

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
07/30/2024
Section Cited
CCR
101170(e)(1)

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101170(e)(1) Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department.
This was not met as evidenced by…
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Director stated she will have A3 complete the background clearance and be associated to the facility. LPA will be sent a copy of background clearance via email.
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Based on interviews and record review uncleared adult (A3) is allowed to spend time and interact on a one to one basis with the children and has not been associated or received background clearances required by Title 22. This poses an immediate health, safety and personal rights 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:Pauline Beschorner
LICENSING EVALUATOR NAME:Anastasia Flores
LICENSING EVALUATOR SIGNATURE:
DATE: 07/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/30/2024


LIC809 (FAS) - (06/04)
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