376600650-9-4-2019-51-CC-JREG-BFPSPA-20190904140250

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376600650
Report Date: 09/04/2019
Date Signed: 09/04/2019 02:02:59 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	KINDERCARE-CARLSBAD		FACILITY NUMBER:	376600650
ADMINISTRATOR:	REBEKAH SITOMPUL		FACILITY TYPE:	850
ADDRESS:	1200 PLUM TREE ROAD		TELEPHONE:	(760) 435-0001
CITY:	CARLSBAD	STATE: CA	ZIP CODE:	92011
CAPACITY:	125	CENSUS: 37	DATE:	09/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Director Rebekah Sitompul		TIME COMPLETED:	12:45 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	Licensing Program Analyst, Joelle Redding, met with Director for the purpose of an unannounced random annual inspection. There were 37 children present with 5 staff as follows: PreK classrooms combined with 17 children a teacher an an Aide, 3 year old room: 12 children and the Assistant Director; Classroom 2A, 9 children with a teacher and Classroom 2B: 9 children with a teacher. The facility is within ratio and capacity. Program operates Monday thru Friday from 6:30 a.m. to 6:30 p.m LPA toured the rooms. The furniture, books, games and toys are safe, age-appropriate and in good repair. Rooms were a comfortable temperature during this visit. No hazards were noted. All storage containers and trashes have tight fitting lids and are in good repair. The facility provides breakfast, lunch and p.m. snack. There is a kitchen which is clean and sanitary with all food stored properly, per regulation. Menus are posted. Hand washing and toileting areas are in a safe, sanitary and in operating condition. Medications are kept in each classroom, inaccessible to children. Poisons, disinfectants, cleaning solutions and other items that are dangerous to children have been made inaccessible. There is no evidence of rodent or insect activity. Outdoor play area is fully fenced with sufficient cushioning and. No hazards were noted. Portable water is used. There are no bodies of water, firearms or ammunition on the property. The carbon monoxide detector is operational. LPA reviewed, sign in/out sheets, a sample of personnel records for a health screening and a sample of children's records for emergency information and a medical assessment. LIC 9224's were on file for the deficiency in June 2019. There is at least one staff present with current CPR and First Aid certification. Isolation area is the Director's office. SB 792 (staff immunizations) and AB 1207 (Mandated Reporter Training) requirements have been met. Effects of Lead Exposure Handout provided for dissemination to parents/guardians. This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

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

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: KINDERCARE-CARLSBAD	FACILITY NUMBER: 376600650
	VISIT DATE: 09/04/2019

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
26
27
28
29
30
31
32

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. Services were in place today.

During this visit, LPA followed up on a self reported incident that occurred on 8/29/19, wherein a 2 year old child (Child #1) tripped in the classroom, sustaining a laceration to the forehead requiring medical attention. Staff #1 who observed the incident stated that she was assisting a child in the bathroom and called out to Child #1 to use walking feet. Child #1 tripped over her own feet and fell forward into the corner of a small shelf. Staff #1 stated that she contacted the Assistant Director to assist, and first aid was administered. Child #1's laceration was sealed with medical glue at the doctor and she returned to school the following day without restriction. LPA evaluated the classroom. No hazards were noted. The furniture in the room was age appropriate. Staff #1 indicated that there were not children or items in Child #1's path that would have caused her to trip. Ratios were met with 10 children and 1 teacher. Supervision was in place, staff responded appropriately and the facility reported timely.

Licensee is advised to sign up for Quarterly Updates and Provider Information Notices (PINs) for one or more programs on our website: www.ccld.ca.gov. Select “Child Care” then “Quick Links” and Quarterly Updates. Select “Receive Important Updates” then put the email address in and choose which program(s) you would like to subscribe to and select “subscribe.”

No deficiencies are cited.

NOTICE OF SITE VISIT WAS POSTED DURING THIS VISIT AND WILL REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Joelle Redding	TELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2