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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334811527
Report Date: 06/29/2021
Date Signed: 06/29/2021 04:23:59 PM

Document Has Been Signed on 06/29/2021 04:23 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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334811527
ADMINISTRATOR:PATRICIA MACIELFACILITY TYPE:
840
ADDRESS:7897 MISSION GROVE PARKWAYTELEPHONE:
(951) 789-4762
CITY:RIVERSIDESTATE: CAZIP CODE:
92508
CAPACITY: 42TOTAL ENROLLED CHILDREN: 0CENSUS: 28DATE:
06/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Director, Patricia MacielTIME COMPLETED:
03:40 PM
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On 06/29/2021 at 10:29am, Licensing Program Analyst (LPA) Destinee Hogue conducted a required annual inspection as part of a compliance review. A tour of the inside and outside of the facility was granted and the following was observed and discussed with Director, Patricia Maciel:

This is a combination center and the other licensed programs were inspected on this date.
A review of the staff records and a sampling of the children's records was conducted as part of this evaluation.
· ZERO TOLERANCE - There are no bodies of water present. All wading pools or similar product must be emptied immediately after use and stored in an upright position.
· ZERO TOLERANCE - No weapons stored at the facility
· Hazards are stored where inaccessible to children which include: disinfectants, cleaning solutions and other items that are dangerous to children.
· Poisons and toxins are locked
· Medications are stored where inaccessible to children. During review of medications for a child(ren) present at the time of this inspection, the label for a child(ren) prescribed medication is faded and illegible to read. LPA Hogue was unable to read the expiration/discard date, and/or the name of the child(ren) the medication belongs too.
· Classrooms are equipped with age appropriate furniture and equipment in good condition
· Outdoor activity areas are supplied with age and size appropriate equipment in good condition
· Playgrounds are enclosed by appropriate fences and free of hazards
· The surface of the outdoor activity space is free of hazards. LPA observed rubber playground cushioning, grass area, and cemented area(s) surrounding the school-age outdoor activity space.
· All toilets, handwashing, and bathing facilities are in safe and operating condition, at this time. LPA issued an Advisory Note-Technical Violation for urine stains on the toilet in the School-age Classroom #1 and water stains around the faucets of the School-age Classroom #1 sink.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2021
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334811527
VISIT DATE: 06/29/2021
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· All floors were observed to be clean and free from hazards. LPA issued an Advisory Note-Technical Violation for observing used paper towels on the floor of the School-age Classroom #1 bathroom and around the classroom sink. During inspection, LPA observed Director Patricia discard used paper towels that were observed on the floor.
· Food preparation area is clean and free of vermin
· Food is stored appropriately and protected from contamination
· All storage containers for solid waste, including moveable bins have tight-fitting covers that were on and in good repair, at this time.
· The areas around or under high climbing equipment, swings, slides, and similar equipment shall be cushioned with material that absorbs a fall.
· The Licensee shall ensure the facility is free of flies, other insects and rodents.
· Appropriate carbon monoxide detector is present and was tested by the Director during this inspection.
· Director understands the Child Care Center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
· ZERO TOLERANCE - The Department has inspection authority as specified in Health & Safety Code sections 1596.852, 1596.853, and 1596.8535.
· The Department shall notify a Licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons. The Licensee shall comply with the notice.
· The facility is operating within the terms of the license.
· A review of staff records on 06/29/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
· A Staff member is present with current Pediatric CPR/First Aid which expires on 10/2022-
· Licensee understand the name of the Child Care Center Director or fully qualified teacher(s) designated to act in the Director's absence shall be reported to the Department within 10 days of a change.
· Sign in/Sign out record was reviewed and meets regulation requirements, at this time.
· Each Staff’s files contain the required health screening as specified in section 101216(g). Licensee/Director understands all personnel, including the Licensee, Administrator and Volunteers, shall be in good health and shall be physically and mentally capable of performing assigned tasks.
· Personnel that pose a threat to the health and safety of children shall be relieved of their duties.
· All personnel shall be given on-the-job training…or shall have related experience that demonstrates knowledge of and skill in…housekeeping and sanitation principles, including universal health precautions.
· The Licensee/Director shall not exceed the conditions, limitations and capacity specified on the license.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334811527
VISIT DATE: 06/29/2021
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· ZERO TOLERANCE - Appropriate supervision was provided during this inspection. Licensee/Director understands No child(ren) shall be left without the supervision, including visual supervision, of a teacher at any time.
· Ratios were met during this inspection. Licensee/Director understands there shall be a ratio of one Teacher supervising no more than 14 children in attendance or one Teacher and one Aide present to every 28 children in attendance.
· Licensee/Director shall ensure that each child is accorded a safe, healthful and comfortable accommodations, furnishings and equipment to meet the child's needs.
· The Licensee/Director is responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.
· The facility is equipped to isolate and care for any child who becomes ill during the day. The Director's office is used as an isolation and care area for ill children.
· Each child’s file contains the required identification and emergency information and medical assessment.
· Menus shall be posted at least one week in advance in a place visible by the child’s authorized
· AB1207 Mandated Child Abuse Reporter training completed on 06/07/2020
· Review of staff records contains proof staff are immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or statement denying the influenza vaccination.
·This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) / (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov

· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

· The Duty Officer is available to answer questions Monday – Friday from 8:00am to 5:00pm at (951)782-4200
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
LIC809 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334811527
VISIT DATE: 06/29/2021
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· Access to forms & Regulations for a Child Care Center are online at www.cdss.ca.gov.

An exit interview was conducted and during the interview, Director, Patricia Maciel confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

See LIC809D for cited deficiencies

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS. Appeal rights were provided and discussed. This report must be available for review, upon request, for the next 3 years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/29/2021 04:24 PM - It Cannot Be Edited


Created By: Destinee Hogue On 06/29/2021 at 11:53 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334811527

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/13/2021
Section Cited
CCR
101226(e)(1)(B)

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Health-Related Services. (e) In centers where the Licensee chooses to handle medications:...(1) All prescription and nonprescription medications shall be centrally stored in accordance with the requirements specified below: (B) Each container shall have an unaltered label.
This requirement was not met as evidenced by:
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Director stated she will return the faded/damaged medication bottle to the child's authorized representative, and agreed to request a new bottle with legible labels. Proof of correction can be sent via email or text message by 07/13/2021.
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During review of medications for a child(ren) present at the time of this inspection, the label on the prescribed medication bottle is faded and illegible to read, and LPA was unable to read the child's name on the bottle. The medication is stored separately from other medications and according to records reviewed, the medication was last given to the child on 06/28/21. This poses a potential health, safety, and personal rights risk to children in care.
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THIS BOX IS INTENTIONALLY LEFT BLANK.

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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:Kimberly Williams
LICENSING EVALUATOR NAME:Destinee Hogue
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2021


LIC809 (FAS) - (06/04)
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