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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600790
Report Date: 05/24/2024
Date Signed: 05/24/2024 03:24:16 PM

Document Has Been Signed on 05/24/2024 03:24 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:KINDERCARE LEARNING CENTER - PASEO LADERA, INFANTFACILITY NUMBER:
376600790
ADMINISTRATOR/
DIRECTOR:
ANA KINGFACILITY TYPE:
830
ADDRESS:1101 PASEO LADERATELEPHONE:
(619) 482-1800
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 56TOTAL ENROLLED CHILDREN: 56CENSUS: 40DATE:
05/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Rosa De La TorreTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 5/24/2024, at 1:00 p.m., Licensing Program Analyst (LPA) Adrian Castellon conducted an unannounced Case Management inspection to follow upon on the Unusual Incident reported to the Department on 3/29/2024. Upon arrival, LPA met with Assistant Director, Rosa De La Torre, and discussed the purpose of the inspection. LPA toured the facility. There were 16 infants present and 4 staff during the inspection.

On 3/29/24 Child, (Bishop Thomas) was playing on a house play structure, climbed through the window and went head first into the ground. Child sustained injury around 9:58am to right eyebrow that required medical attention. Mother of C1 was contacted and picked up child to take to the hospital. C1 returned to the facility after the hospital visit. There were 4 teachers present and 16 children on the playground at the time of the injury. Three of the staff members were interviewed on this date. LPA telephoned mother but did not make contact.

Based on interviews conducted, staff observed C1 fall and injure themselves. Incident was properly reported to child representative and to the Licensing Office.

No deficiencies cited during today’s inspection.

A Notice of Site Visit was given and must remain posted on, or immediately next to, interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2024
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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