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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801329
Report Date: 08/30/2022
Date Signed: 08/30/2022 10:21:23 AM

Document Has Been Signed on 08/30/2022 10:21 AM - 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KINDERCARE LEARNING CENTER, #1015FACILITY NUMBER:
103801329
ADMINISTRATOR:AVALOS, TASHAFACILITY TYPE:
850
ADDRESS:1785 VILLA DRIVETELEPHONE:
(559) 297-1888
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 45DATE:
08/30/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Tasha Avalos - DirectorTIME COMPLETED:
10:30 AM
NARRATIVE
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On 8/30/22 Licensing Program Analyst (LPA) Joseph Pacheco arrived at the facility to conduct an unannounced Case Management Inspection. LPA toured the facility and a census was taken. An Unusual Incident was reported to Community Care Licensing on 7/26/22. On 7/26/22 Staff #1 was escorting Child #1 to the office because Child #1 was throwing chairs in the classroom. Staff #2 was walking behind and alleged that Staff #1 was mishandling Child #1 causing fingernail marks and redness to the arm of Child #1. Staff #2 reported the incident to Assistant Director, Beatrice Alvarez. Child #1 did not require medical attention. Facility immediately suspended and after conducting an investigation made the decision to terminate Staff #1 and they are no longer employed at this facility.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D). Licensee was provided a copy of their appeal rights.

LPA Joseph Pacheco informed Director, Tasha Avalos that this report dated 8/30/22 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.
Also, LPA Joseph Pacheco informed Director, Tasha Avalos to provide a copy of this licensing report dated 8/30/22 that documents any Type A citation 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 conducted and report was reviewed with the Director, Tasha Avalos. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2022
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 08/30/2022 10:21 AM - It Cannot Be Edited


Created By: Joseph Pacheco On 08/30/2022 at 10:06 AM
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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINDERCARE LEARNING CENTER, #1015
FACILITY NUMBER: 103801329

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2022
Section Cited
CCR
101223(a)(1)

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Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by Director statement that Staff #1 was terminated for inappropriate handling of a
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Facility has taken steps to remedy the situation by suspending and terminating the employment of Staff #1. Deficiency cleared.
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child. This is an immediate danger to the health, safety or personal rights of 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:Diana deLeon
LICENSING EVALUATOR NAME:Joseph Pacheco
LICENSING EVALUATOR SIGNATURE:
DATE: 08/30/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/30/2022


LIC809 (FAS) - (06/04)
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