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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364830082
Report Date: 11/20/2023
Date Signed: 11/29/2023 01:43:24 PM

Document Has Been Signed on 11/29/2023 01:43 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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364830082
ADMINISTRATOR:BRIANNE HINDMANFACILITY TYPE:
830
ADDRESS:13615 BEAR VALLEY ROADTELEPHONE:
(760) 949-8539
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 20DATE:
11/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:14 AM
MET WITH:Jennifer Johnson, Site DirectorTIME COMPLETED:
01:45 PM
NARRATIVE
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On November 29, 2023, Licensing Program Analyst (LPA) Calloway met with the facility Director, for the purpose of an Annual/Random inspection of the infant center component. LPA toured the center with the Director and observed seven (7) infants and two (2) teachers inside in active play, and eleven (11) toddlers, two (2) infants, and four (4) teachers outside in active play. The infant center consists of 2 classrooms (1 for the babies and younger children; 1 for the active toddlers). The facility operates from Mon.- Fri. 6:30 am to 6:30 pm. Incidental Medical Services (IMS) were discussed. Center currently has no children in the infant program requiring IMS.

Infant area: LPA observed several crib/play yards for each child in care. Bottles, dishes, sip cups, and containers were observed (labeled). Changing tables are within arm's reach of sink. Ointments and sunscreen are kept in individual plastic sealed bags above changing table with documents of parent and/or physician's signed permission (key lock). Furniture and equipment were inspected for age appropriateness, good repair, cleanliness, and safety. LPA observed soap, and paper towels readily available. Telephone service was verified. The facility has intercom systems that operate in each classroom and outside and walkie talkies. Locked storage cabinets. Heating, lighting, and ventilation are adequate. Two (2) small refrigerators with water cups and bottled milk (labeled) temperature adequate for storage. Per staff, floors are mopped and vacuumed daily, and carpets steam cleaned once a month. In the young infant's classroom, names labeled under the changing table with their diapers, kept locked.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364830082
VISIT DATE: 11/20/2023
NARRATIVE
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In toddler classroom, LPA observed age-appropriate toys, furniture, books, and materials. LPA observed cots available for napping children. Per staff cots, bibs and sheets are cleaned daily. Staff use the restroom in the hallway. The bedding is stored separately. Fire extinguishers (near exit door), smoke detector/ carbon monoxide detector (operable). Sprinkler system in the ceiling and fire alarm pull observed. Trash cans with lids and unused outlets (covered). Current Pediatric CPR and First Aid certificates were observed (expires: 2/2025).
Kitchen: Fully equipped kitchen with refrigerator, freezer, 2 ovens, steamer and four (4) sinks. The facility provides breakfast, lunch and afternoon snacks. Weekly menus are posted in the lobby, in the hall, and in the kitchen. Allergy lists are posted in each classroom and in the kitchen. LPA observed an appropriate amount of food and snacks. The chemicals are kept in the laundry room separate from the food.
Outdoors: Play equipment was inspected for health, safety, cushioning material, good repair and age appropriateness. There are 3 playgrounds that are physically separated from the other components by chain link fences with securely anchored large play structures (preschool and school age) and grassy areas for active play. All play structures are shaded with padded floors for cushioning underneath. There are areas for rest (canopy). Drinking water provided with individual sip cups and a water pitcher observed in the outdoor play area. Per staff they are cleaned regularly. The area was observed to be free of debris. Play area was inspected for hazards and inaccessibility to bodies of water. There were no bodies of water on the premises.
Others: Daily Name-to-Face logs were observed in each classroom. Sign in/out sheets were observed. Emergency backpacks are kept hanging on the wall in each classroom. Staff and children’s files reviewed. LIC 9227 forms and infant Safe Sleep logs (verified). Postings (current) Roster (Current). Disaster, Fire/Earthquake drills (current). Care and supervision were evaluated to determine if the basic needs of children are met and appropriate.
SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
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
PALMDALE CHILD CARE, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364830082
VISIT DATE: 11/20/2023
NARRATIVE
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Children are inspected for illnesses as they arrive. A review of medication policy indicated that prescription medication is administered and only with parent's written permission. Only trained staff (teachers or director) administer medication and document the dosage, date, and time onto a log. Medication is brought and taken home by the parent daily or retained in a lock box properly labeled and stored in its original container. There is a separate area for isolation and care of ill children inside the Learning Adventures room. There is separate napping equipment with fresh linens available for each ill child. During the inspection LPA verified that IMS services were not being provided at this time. This facility does not provide Incidental Medical Services – IMS. 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. Center reminded to review updates/regulations as well quarterly updates on the department website@ www.ccld.ca.gov . Teacher/child ratios were observed. The Director was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC 9224) form is placed in the children’s files.

Per Title 22 Regulations, there are deficiencies cited during today's inspection. See 809 D pages.

Exit interview was conducted and a copy of this report was read, and Notice of Site Visit and Appeal Rights were provided to Jennifer Johnson, Site Director.

SUPERVISORS NAME: Claretta Yates
LICENSING EVALUATOR NAME: Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/29/2023 01:43 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 11/29/2023 at 01:35 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364830082

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in S4 did not have immuniztion records in their files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2023
Plan of Correction
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Director will provide proof by POC date 12/15/23
Type B
Section Cited
CCR
101415(c)
Infant Care Center Director Qualifications and Duties
(c) At least three of the semester or equivalent quarter units required in Sections 101215.1(h)(1)(B), (h)(2) and (h)(3) shall be related to the care of infants.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in S4 did not have transcripts in staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2023
Plan of Correction
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Director will provide proof by POC date 12/15/23
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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/29/2023 01:43 PM - It Cannot Be Edited


Created By: Kuliema Calloway On 11/29/2023 at 01:35 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
, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364830082

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above in three children C1, C7, C12, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/15/2023
Plan of Correction
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Director will provide proof by POC date of 12/15/23
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Claretta Yates
LICENSING EVALUATOR NAME:Kuliema Calloway
LICENSING EVALUATOR SIGNATURE:
DATE: 11/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/29/2023


LIC809 (FAS) - (06/04)
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