<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364809074
Report Date: 07/27/2023
Date Signed: 07/27/2023 06:05:05 PM

Document Has Been Signed on 07/27/2023 06:05 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:
364809074
ADMINISTRATOR:SALVADOR-RIVERA, JESSICAFACILITY TYPE:
830
ADDRESS:16149 FOOTHILL BOULEVARDTELEPHONE:
(909) 823-2323
CITY:FONTANASTATE: CAZIP CODE:
92335
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 20DATE:
07/27/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Sabrina KatzTIME COMPLETED:
06:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On the date and time stated above, Licensing Program Analyst (LPA) Aman Sharma arrived at the facility on a case management inspection to follow up on an incident reported via telephone. The incident was called in on 07/21/23 by facility director, Sabrina Katz. Upon arrival, LPA was met with facility director to discuss the reported incident. LPA toured the facility, including the location where the incident took place, and took census.

It was disclosed that the incident occurred on 07/20/23 at approximately 9:00am. During transition from indoor to outdoor activity, a child was left indoors, in the toddler classroom, unsupervised, from anywhere from 4-10 minutes. It was also disclosed that the director walked by the classroom and heard "banging" on the door of the toddler classroom. The director looked inside and found the subject child in the toddler classroom, unsupervised and alone.
During today's inspection, LPA spoke with staff who were present in the indoor to outdoor transition on the date of the incident. Children interviews were not obtained, since children are infants and are non-verbal.

See LIC809D for cited deficiency in accordance with the California Code of Regulations, Title 22, Division 12 for lack of supervision.

An exit interview was conducted, appeal right discussed, Notice of Site Visit and must remain posted for 30 days. A copy of this report was provided. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/27/2023 06:05 PM - It Cannot Be Edited


Created By: Aman Sharma On 07/27/2023 at 05:14 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: 364809074

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2023
Section Cited
CCR
101429(a)(1)

1
2
3
4
5
6
7
101429 Responsibility for Providing Care and Supervision for Infants: (a) In addition to Section 101229, the following shall apply:(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This was not met as evidenced by:
1
2
3
4
5
6
7
All 3 staff were re-trained on transitioning from outdoor to indoors (were given a booklet). Staff were re-trained on signing children in/out and making transition times fun for the kids. Director or assistant director will be assisting during transitioning times. Director stated that the classroom is now
8
9
10
11
12
13
14
Staff was unaware that a chil was left in the classroom by themselves. The child was baning on the door and that's when facility staff noticed a child by themselves in the classroom.
8
9
10
11
12
13
14
only allowed to have 4 children outside at a time, so that way they ensure that there's one teacher inside with them at all times. Director agrees to begin a log for transition times and submit proof of a log to licensing by POC due date. A future office visit will be scheduled.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Aman Sharma
LICENSING EVALUATOR SIGNATURE:
DATE: 07/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/27/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2