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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073401322
Report Date: 01/25/2023
Date Signed: 01/25/2023 05:22:15 PM

Document Has Been Signed on 01/25/2023 05:22 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, #1039FACILITY NUMBER:
073401322
ADMINISTRATOR:SAUTER, LISAFACILITY TYPE:
850
ADDRESS:2300 MAHOGANY WAYTELEPHONE:
(925) 778-8888
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 95TOTAL ENROLLED CHILDREN: 51CENSUS: 30DATE:
01/25/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Lisa SauterTIME COMPLETED:
05:30 PM
NARRATIVE
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On 01/25/23 at 3:45PM, Licensing Program Analyst (LPA) Christina Watts met with Director, Lisa Sauter and Assistant Director Selene Acosta to conduct a Case Management inspection for the Lead Testing results at Kindercare Learning Center.

It was indicated that there were 1 outlet which exceeded the Action Level established by the State for exposure. Facility submitted test results on 01/13/2023 with LIC 9275 and LIC 9276 along with an update facility sketch of location of outlets. LPA Watts spoke with the Assistant Director on 01/18/2023. Assistant Director stated the facility is currently not using the water fountains and children are provided cups and drinking water. Assistant Director sent Plan of Correction for outlets.

During today's inspections, LPA conducted an inspection and toured the premises with Director, Lisa. LPA observed the outlet located in the outdoor infant/toddlers play yard was used for drinking water prior to pandemic. Since pandemic, facility ceased to use drinking fountains and children use cups of water. LPA observed outlet have been made inaccessible to children. The facility plans to retest the outlet.

Due to outlets being in use by children for drinking water before pandemic, children were potentially exposed to lead which is a risk to their health and safety. Deficiency is cited on page 809D. LPA discussed a Plan of Correction and facility has now submitted the documentation for the post-testing requirements.

Exit interview conducted and report was reviewed with the Director, Lisa Sauter and Assistant Director, Selene Acosta. A Notice of Site Visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2023
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 01/25/2023 05:22 PM - It Cannot Be Edited


Created By: Christina Watts On 01/25/2023 at 04:40 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, #1039
FACILITY NUMBER: 073401322

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/24/2023
Section Cited

101700.3(b)(2)

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(b)(2) Licensees shall maintain a lead value at or below the Action Level of 5 ppb in all outlets subject to the testing requirements of these Written Directives, for the health and safety of children in care. This requirement is not met as evidenced by:
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By COB 02/24/2023, facility will have retested outlet and send results to licensing.
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Per Lead Testing results, there is 1 drinking water outlet inside the facility with lead exceedance. Director states outlet have not been used since pandemic. Since they were in use before pandemic, this poses/posed potential risk to health/safety of children.
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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Christina Watts
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2023


LIC809 (FAS) - (06/04)
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