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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093608580
Report Date: 04/08/2024
Date Signed: 04/08/2024 02:10:35 PM


Document Has Been Signed on 04/08/2024 02:10 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:KINDERCARE LEARNING CENTER - PARK (PS)FACILITY NUMBER:
093608580
ADMINISTRATOR:GALVAN, VERONICAFACILITY TYPE:
850
ADDRESS:3959 PARK DR.TELEPHONE:
(916) 939-0391
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:116CENSUS: 80DATE:
04/08/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Veronica GalvanTIME COMPLETED:
02:25 PM
NARRATIVE
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On April 8th, 2024, Licensing Program Analyst (LPA) Soleil Marx met with Director, Veronica Galvan, for the purpose of conducting a Case Management Inspection. The purpose of today's inspection was explained. LPA observed a census of 80 preschool children in care being supervised by eight staff.

Sacramento RO received an Unusual Incident Report from the facility self-reporting an absence of supervision incident that occurred on April 2nd, 2024. During today's inspection, LPA made observations, reviewed relevant documentation, and interviewed the Director and staff regarding the incident. LPA determined by incident report and interview that two staff members transitioned the pre-k classroom to the outdoor activity space, leaving a child unattended inside of the pre-k classroom for at least ten minutes. The child was found inside the classroom by the cook who was delivering a lunch tray. Director stated that the two staff members involved were trained on using the Child Supervision Record (CSR) system for transitioning, which includes attendance counts and name to face checks. It was determined by interview and record review that the staff involved made an error on their CSR check during their transition from inside to outside. Director stated that the staff involved in the incident have received disciplinary action and are being re-trained on CSR protocol, name to face checks and supervision.

Based on Today’s inspection, One Title 22 deficiency is being cited on 809-D and an immediate civil penalty of $500 is being assessed.


Licensee was informed that this report dated 04/08/2024 documents one Type A citation which shall be posted for 30 consecutive days. The Licensee shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
Exit interview was conducted and a copy of this report was given to the Director. Notice of site was provided and must remain posted for 30 days. Appeal rights provided.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil MarxTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2024
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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Document Has Been Signed on 04/08/2024 02:10 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: KINDERCARE LEARNING CENTER - PARK (PS)
FACILITY NUMBER: 093608580

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/09/2024
Section Cited
CCR
101229(a)(1)

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The licensee shall provide care and supervision as necessary to meet the children's needs. No child shall be left without the supervision of a teacher at any time..Supervision shall include visual observation.
This requirement is not met as evidenced by:
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Diretor stated she is adding an additional transition checkpoint for the CSR checks, and re-training entire staff on supervision and the CSR method for attendance and name to face checks. Director will submit training material and staff attendance signatures to LPA Marx by POC due date.
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Based on interview and record review, the licensee did not ensure compliance of the section cited above by leaving a child in a classroom without supervision, which poses an immediate Health,Safety, or Personal Rights risk to persons in care.
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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: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil MarxTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 04/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2024
LIC809 (FAS) - (06/04)
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