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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364844526
Report Date: 09/22/2021
Date Signed: 09/22/2021 11:03:40 AM

Document Has Been Signed on 09/22/2021 11:03 AM - 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:
364844526
ADMINISTRATOR:BRITTANY MCGUIREFACILITY TYPE:
840
ADDRESS:10451 COMMERCE ST.TELEPHONE:
(909) 796-9686
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY: 26TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
09/22/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Brenda SandavolTIME COMPLETED:
11:15 AM
NARRATIVE
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On 09/22/21 at 09:00am Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the Facility for another purpose. LPA met with Acting Director, Brenda Sandavol.

Based on observations, records review and interviews conducted for a visit on 09/03/2021, LPA discovered the facility had knowledge of an unusual incident regarding care and supervision of a child in care and failed to report it to Licensing. In addition, the facility was unable to locate and provide LPA a complete file for review.

The facility was found to be in violation of the following Title 22 regulations: Reporting Requirements and Child’s Records. This is a Potential risk to the health and safety of children in care.

See LIC809D for Type B Deficiencies


An exit interview was conducted with Acting Director


A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE DIRECTOR UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS

Appeal rights were provided and discussed. A copy of this report was given to the Director on this date and must be made available to the public upon request for the next 3 years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2021
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 09/22/2021 11:03 AM - It Cannot Be Edited


Created By: Justin Giese On 09/21/2021 at 02:05 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: 364844526

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/22/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/29/2021
Section Cited
CCR
101221(a)

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Child's Records - A separate, complete and current record for each child is maintained in the child care center.



This requirement has not been met as evidenced by:
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Facility Director understands the importance of maintaining children's files and will have staff conduct an audit of files to assure that all children currently enrolled and on the facility roster have a file for review. Documentation of training/proof of correction will need to be submitted to LPA on or before the date of correction, 09/29/2021
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Based on observations fron a visit on 09/03/2021 LPA requested a review of a Child’s file for the purpose of verifying the documentation. The facility was unable to locate the Child’s file for review. This poses a potential risk to the health and safety of children in care.
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Type B
09/30/2021
Section Cited
CCR101221(d)(1)(C)

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Reporting Requirements - Any unusual incident or child absence that threatens the physical or emotional health or safety of a child shall be reported to the Department within 24 hours of the occurrence.

This requirement has not been met as evidenced by:
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Facility Director understands the importance of reporting requirements and documentation of unusual incidents that occur in the facility. Facility Director will conduct training with staff and members of management on proper procedures for self-reporting and documenting unusual incidents that occur at the facility and the proper time frame they must be reported
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Based on interviews conducted with staff on 09/03/2021, LPA discovered the facility had knowledge of an unusual incident which occured on 08/24/21 regarding care and supervision of a child in care and failed to report it to Licensing. This poses a potential risk to the health and safety of children in care.
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to licensing. Documentation of training/proof of correction will need to be submitted to LPA on or before the date of correction, 09/29/2021
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:Justin Giese
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2021


LIC809 (FAS) - (06/04)
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