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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207886
Report Date: 07/29/2021
Date Signed: 07/29/2021 04:07:22 PM

Document Has Been Signed on 07/29/2021 04:07 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:KINDERCARE LEARNING CENTER CAMFACILITY NUMBER:
566207886
ADMINISTRATOR:JENNIFER BREWERFACILITY TYPE:
830
ADDRESS:2360 PICKWICK DR.TELEPHONE:
(805) 445-8485
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY: 44TOTAL ENROLLED CHILDREN: 0CENSUS: 16DATE:
07/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:32 PM
MET WITH:Jennifer BrewerTIME COMPLETED:
01:45 PM
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On July 29, 2021 at 12:38 pm, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA met with facility Director Jennifer Brewer and advised her the purpose of the inspection. Prior to conducting the tour of the facility, LPA conducted Covid-19 screening questions. Director provided LPA a tour of the facility inside and out. There were 16 children in care at the time of the inspection.

Licensing required notices were posted prominently on the wall in the front lobby. The facility uses four classrooms for children in care. Classrooms one and two are for the younger children/infants. Each classroom was observed to be within teacher to child ratio. LPA observed age appropriate toys and furnishings. The classroom had a changing table with sink readily accessible. LPA observed enough cribs for the infants in care. Facility had current sleep logs. Food and milk is stored within a refrigerator located in the classroom. LPA reviewed a sampling of Individual needs & services plans and feeding plans. Children bottles and food were properly labeled with child's name and date. LPA did not observe any toxins/hazardous items accessible to children. LPA observed where the facility secures medications.

Continued on 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KINDERCARE LEARNING CENTER CAM
FACILITY NUMBER: 566207886
VISIT DATE: 07/29/2021
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Center uses the electronic application Kinder Care. A sampling of children and staff records were reviewed. Teachers have required qualifications. Teachers present have current Pediatric First Aid/CPR certificates that expire on 10/02/2022. Teachers present have current AB 1207 Mandated Reporter Training certificates that expire on 2/12/2023. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Facility is follow current Covid-19 and Safe Sleep guidelines.

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 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

No deficiencies were cited during today's visit.



THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
LIC809 (FAS) - (06/04)
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