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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103801757
Report Date: 08/18/2021
Date Signed: 08/18/2021 01:27:38 PM

Document Has Been Signed on 08/18/2021 01:27 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
103801757
ADMINISTRATOR:SANCHEZ, YESENIAFACILITY TYPE:
850
ADDRESS:1190 W. HERNDONTELEPHONE:
(559) 438-7740
CITY:PINEDALESTATE: CAZIP CODE:
93650
CAPACITY: 68TOTAL ENROLLED CHILDREN: 0CENSUS: 35DATE:
08/18/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Yesenia SanchezTIME COMPLETED:
01:45 PM
NARRATIVE
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On 08/18/21, Licensing Program Analysts (LPAs) Angelica Slaughter and Jeovanna Yanez conducted an unannounced Case Management inspection at the facility. During this inspection, child sign in/sign out sheets were reviewed and it was noted several parents are not properly signing their children in/out. Two parents signed their child in/out for the day. Another parent signed their child in/out for the week. Four parents did not sign their children out over the last two days and one parent did not sign their child in for the last two days. This is a violation of the regulations. A citation is being issued for this violation. A copy of this report, as well as appeal rights was provided to the facility Director.

(See 809 D)
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Angelica Slaughter
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2021
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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Document Has Been Signed on 08/18/2021 01:27 PM - It Cannot Be Edited


Created By: Angelica Slaughter On 08/18/2021 at 12:25 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
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 103801757

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/23/2021
Section Cited
CCR
101229.1(a)(1)(b)

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Sign In and Sign Out. The licensee shall develop, maintain, and implement a written procedure to sign the child in/out of the child care center that shall, at a minimum, include the following: The person who signs the child in/out shall use his/her full legal signature and shall record the time of day.
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Director will be sending out an email to all parents/authorized representatives of the facility's sign in/out procedures. Director will assign a staff member to stand outside to ensure that parents are signing in/out properly as required by the CCLD regulations.
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The person who brings the child to, and removes the child from, the center shall sign the child in/out. This requirement was not met as evidenced by review of child sign in/out sheets. This is a possible risk to the health, safety or personal rights of children in care.
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Staff will also be met with and trained on the procedures for parent's properly signing children in and out. A completed POC will be submitted to CCLD by the POC due date of 08/23/21.

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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:Angelica Slaughter
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2021


LIC809 (FAS) - (06/04)
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