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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364809072
Report Date: 12/19/2024
Date Signed: 12/19/2024 04:54:49 PM

Document Has Been Signed on 12/19/2024 04:54 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:
364809072
ADMINISTRATOR/
DIRECTOR:		SABRINA KATZFACILITY TYPE:
850
ADDRESS:16149 FOOTHILL BOULEVARDTELEPHONE:
(909) 823-2323
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 36DATE:
12/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Sabrina Katz TIME VISIT/
INSPECTION COMPLETED:
05:10 PM
NARRATIVE
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On the date and time listed above, Licensing Program Analyst (LPA) Aman Lama arrived at the facility on another matter. LPA was granted access to the center by site director, Sabrina Katz. LPA took a tour of the facility as well as the census of children.
On 12/02/2024, the center called in an incident that occurred at the facility involving a preschool child in the discovery classroom. The incident involved a child's index finger getting wedged in between the space between the door and hinge.
No Unusual Incident Report was submitted within 7 days of the initial phone call.
This is a violation of Title 22 Regulations, section 101212(d)(1)(C).
SEE LIC809D for cited deficiencies.

An exit interview was conducted, a copy of this report and Notice of Site Visit were provided to the site director, Sabrina Katz. LPA observed the Notice of Site Visit form was posted by staff.

The Notice of Site must be posted for 30 consecutive days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Aman Lama
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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 12/19/2024 04:54 PM - It Cannot Be Edited


Created By: Aman Lama On 12/19/2024 at 04:40 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: 364809072

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/24/2024
Section Cited
CCR
101212(d)(1)(C)

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(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the info
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Director agrees to submit an Unusual Incident Report (UIR) for the incident called in from 12/02/2024, no later than the POC due date.
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specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (C)Any unusual incident or child absence that threatens the physical or emotional health or safety of any child. This was not met as >>
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evidenced by: The center did not submit an Unusual Incident Report (UIR) in a timely manner, within the 7 days allotted. This poses/posed a potential health and safety 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:Gilbert Sena
LICENSING EVALUATOR NAME:Aman Lama
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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