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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334812759
Report Date: 12/22/2023
Date Signed: 12/22/2023 01:18:56 PM

Document Has Been Signed on 12/22/2023 01:18 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334812759
ADMINISTRATOR:JESSICA SALVADOR-RIVERAFACILITY TYPE:
830
ADDRESS:1080 HIGHGROVETELEPHONE:
(951) 371-9346
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 16DATE:
12/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Assistant Director, Deanna GroveTIME COMPLETED:
01:25 PM
NARRATIVE
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A case management visit was conducted on 12/22/2023 at 11:35 AM in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 12/04/2023. It was reported that on 12/4/2023 a child had cut their finger on a toy container which resulted in a trip to the Emergency Room. The incident was immediately reported to the department, parents were contacted, and first aid administered to the child’s finger.

Facility records were reviewed, and staff was interviewed. Based on the information gathered, the following violations have been identified: During the staff interview, staff disclosed another staff in the child’s classroom was aware of the broken container approximately a week prior to the incident, however, the staff did not dispose of the broken container which posed an immediate risk to the health and safety to the children in care.

See LIC809-D for cited deficiencies of the California Code or Regulation, Title 22, Div. 12

An exit interview was conducted, appeal rights discussed, and report was reviewed with the Asstant Director, Deanna Grove.

A Notice of Site Visit was issued and is to be posted in a prominent location at the facility for the next 30 days.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Claudia Caywood
LICENSING EVALUATOR SIGNATURE: DATE: 12/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2023
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 12/22/2023 01:18 PM - It Cannot Be Edited


Created By: Claudia Caywood On 12/22/2023 at 12:49 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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334812759

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/26/2023
Section Cited
CCR
101223(a)(2)

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Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights: (2)To be a ccorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by:
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Asst. Director will be addressing with all staff the importance of environmental safetly and classroom maintenance and will require a responce in a group chat that they all understand the message by the POC due date by 12/26/2023
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Staff disclosed to LPA another staff in the child's classroom did not dispose of a broken plastic container which posed an immediate health and safety risk to the children in care resulting in the child cutting their finger on a broken plastic container.
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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:Gilbert Sena
LICENSING EVALUATOR NAME:Claudia Caywood
LICENSING EVALUATOR SIGNATURE:
DATE: 12/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2023


LIC809 (FAS) - (06/04)
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