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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003097
Report Date: 12/16/2021
Date Signed: 12/16/2021 03:57:25 PM

Document Has Been Signed on 12/16/2021 03:57 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003097
ADMINISTRATOR:MARGIE ZARATEFACILITY TYPE:
850
ADDRESS:3443 S. NOGALES STREETTELEPHONE:
(626) 965-9611
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY: 60TOTAL ENROLLED CHILDREN: 70CENSUS: 51DATE:
12/16/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Valerie Rodriguez, Assistant DirectorTIME COMPLETED:
04:00 PM
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An unannounced Case Management - Incident visit was held by Licensing Program Analyst (LPA) Thelma Razo and met with Assistant Director Valerie Rodriguez. LPA stated the purpose of the visit is due to Unusual Incident which occurred on 12/7/2021 and was self reported the following day by Director Margie Zarate to Community Care Licensing Division (CCLD). The Unusual Incident was reported within the required time frame per regulation.

During today's inspection, LPA interviewed 3 staff. LPA toured the center with Assistant Director to include preschool playground, 3 preschool classrooms and bathrooms. LPA observed 51 children with 5 staff in the classrooms during the tour. LPA obtained staff and children's roster and other pertinent documents.

No deficiencies were cited in accordance with California Code of Regulations Title 22 at this time.

The Notice of Site Visit (LIC 9213) was posted and must remain for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.



Exit interview conducted, Appeal Rights explained and a copy was given together with the report.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2021
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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