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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343602980
Report Date: 09/28/2022
Date Signed: 09/28/2022 02:39:19 PM

Document Has Been Signed on 09/28/2022 02:39 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - BRUCEVILLE (PS)FACILITY NUMBER:
343602980
ADMINISTRATOR:ALYSSA DIPIPPOFACILITY TYPE:
850
ADDRESS:9394 BRUCEVILLE ROADTELEPHONE:
(916) 684-4040
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 49DATE:
09/28/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Alyssa DiPippoTIME COMPLETED:
04:30 PM
NARRATIVE
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On 09/28/2022, Licensing Program Analyst Katy Maestas (LPA) conducted a field visit to the Center. LPA arrived at the Center and was met by Director Alyssa DiPippo (D1). LPA disclosed the purpose of the inspection and was granted entrance into the Center. LPA toured the Center and observed 49 preschool-aged children being supervised by 4 adults at nap time. LPA determined through accessing Guardian that 3 of the adults were background cleared and associated to the license; however, 1 adult was not associated to the license.

As a result, 1 deficiency was cited on a subsequent 809-D page. An exit interview was conducted, and the report was reviewed with D1. Licensee Appeal Rights were provided. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2022
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 09/28/2022 02:39 PM - It Cannot Be Edited


Created By: Nola Maestas On 09/28/2022 at 02:20 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - BRUCEVILLE (PS)
FACILITY NUMBER: 343602980

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/29/2022
Section Cited
CCR
87355(e)(1)

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87355 Criminal Record Clearance (e) All individuals subject to criminal record review...shall prior to working...in a licensed facility: (1) obtain a California clearance...as required by the Department. This requirement is not met as evidenced by:
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Director will utilize Guardian to immediately associate the staff member to the license. In the future, Director will familiarize herself with Guardian and call the Officer of the Day for verification once any individual is cleared.
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Based on observation and record review, the Director did not ensure a criminal clearance was obtained for 1 staff member which poses an immediate health, safety and or personal rights risk to chidlren 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:Jeanne Smith
LICENSING EVALUATOR NAME:Nola Maestas
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2022


LIC809 (FAS) - (06/04)
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