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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013415772
Report Date: 08/13/2021
Date Signed: 08/13/2021 05:33:39 PM

Document Has Been Signed on 08/13/2021 05:33 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
013415772
ADMINISTRATOR:WOOLSEY, SIERRAFACILITY TYPE:
850
ADDRESS:11925 AMADOR VALLEY COURTTELEPHONE:
(925) 875-0400
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 108TOTAL ENROLLED CHILDREN: 0CENSUS: 30DATE:
08/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Scott Kinser, Assistant DirectorTIME COMPLETED:
05:15 PM
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08/13/2021, at approximately 10:30am, Licensing Program Manager Chandra Charles, met with Assistant Director Scott Kinser, for a UNANNOUNCED REQUIRED RANDOM INSPECTION OF THE PRESCHOOL COMPONENT OF THIS COMBINATION DAY-CARE CENTER. Initially, present during the inspection were (7) staff personnel and (30) children. Licensing Program Manager Chandra Charles, toured the Preschool facility inside and outside for an Health and Safety Inspection.
CLASSROOMS
The Preschool Center (which includes the Transitional Kindergarten) consists of 4 classrooms but only three classrooms were being utilize on the day of the site inspection. All classrooms are equipped with age appropriate toys, and learning materials. The rooms are clean, organized and have age appropriate size furniture in good repair. Each classroom has a working carbon monoxide detector, fire extinguisher, and pull down fire alarm devices.

There are working restrooms in all of preschool rooms for the children usage. The staff utilizes the bathrooms in the front of the day-care facility. LPM observed there are tight fitting lids on trash cans located inside and outside of the center. There are storage bins and hooks for the children belonging.

FOOD PREPARTION AREA LPM inspected the kitchen area. This area is inaccessible to the day-care children. The kitchen was clean, and organized. Food that needs to be stored in the refrigerator are properly being stored at the appropriate temperature. Food menus are posted in the various classrooms.
OUTSIDE
The outside play area is completely fenced. The play yard consist of a grassy area, concrete area and a play structure which sit on cushion material that absorbs falls. The play structure is properly anchored to the ground. There is a hard canopy that is attached to the play structure which provide shade. Outdoor play area was free of hazards. All outside drinking faucets have been disable (do to covid). The children each have their own water bottles.
RECORDS
A review of staff records on 08/13/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. (7) Personnel files were reviewed. The teacher/child ratio was being met. (5) random children's files were reviewed. Facility roster was reviewed.
Opening and closing staff have current CPR and first aid training. The Center documents and conducts fire/disaster drills with the last one documented on 08/02/21.
POSTING
All proper documents that need to be posted are posted in a highly visible place for parental review.
SUPERVISORS NAME: Anika Evans
LICENSING EVALUATOR NAME: Chandra Charles
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2021
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 013415772
VISIT DATE: 08/13/2021
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This facility provides Incidental Medical Services-IMS. LPA reviewed the storage of medication and equipment and supplies, and reviewed children’s, personnel, and administrative records. LPA discussed the need to update the centers plan of operation to reflect IMS plan. Specifics on the plan can be found in the child care center evaluator manual (CCC EM) Policy 101173. The following information regarding ADA was provided to licensee… US DOJ toll free ADA Information Line (800) 514-0301 and the link to FAQ about child care and ADA http://www.ada.gov/childqanda.htm

California Law requires Child Care Centers to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

Licensee is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter.



For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list

Assistant Director was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.

SUPERVISORS NAME: Anika Evans
LICENSING EVALUATOR NAME: Chandra Charles
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
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