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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013412625
Report Date: 04/26/2023
Date Signed: 04/26/2023 01:46:35 PM

Document Has Been Signed on 04/26/2023 01:46 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTER, #1335FACILITY NUMBER:
013412625
ADMINISTRATOR:WRIGHT,TIFFANIEFACILITY TYPE:
850
ADDRESS:2155 NORTH LOOP ROADTELEPHONE:
(510) 521-3227
CITY:ALAMEDASTATE: CAZIP CODE:
94502
CAPACITY: 81TOTAL ENROLLED CHILDREN: 81CENSUS: 49DATE:
04/26/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Patricia BallanceTIME COMPLETED:
01:50 PM
NARRATIVE
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On 4/26/23, at 12:15PM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced on case management and met with Director Patricia Ballance. Present in care were 49 preschoolers and eight additional staff members.

While at the center regarding another matter, LPA Fernandes and Director Ballance did a walk through of the center and observed the following deficiency. At 12:37PM, while touring the outdoor play areas, LPA observed the grass areas to be uneven with dips throughout the space, dry hard dirt spots and patches of grass which is a potential falling hazard to children in care.

See 809D for deficiency.

Notice of site visit must be posted for 30 days.

Exit interview conducted
Report, Appeal Rights and Report provided.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2023
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 04/26/2023 01:46 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 04/26/2023 at 12:56 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER, #1335
FACILITY NUMBER: 013412625

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/26/2023
Section Cited
CCR
101238.2(d)

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Outdoor Activity Space
The surface of the outdoor activity space shall be maintained: 1) In a safe condition for the activities planned. (2) Free of hazards including, but not limited to, holes, broken glass and other debris, and dry grasses that pose a fire hazard. This requirement has not been met as evidenced by:
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The center will come up with a scheduled plan to repair the outdoor grass area then send pictures to CCL by proof of correction date.
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Based on LPA observation the outdoor play space has not been maintained which is a potential safety hazard for children 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:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2023


LIC809 (FAS) - (06/04)
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