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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003101
Report Date: 04/12/2023
Date Signed: 04/12/2023 03:39:37 PM

Document Has Been Signed on 04/12/2023 03:39 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003101
ADMINISTRATOR:MARY BRAMMERFACILITY TYPE:
850
ADDRESS:18727 CARMENITATELEPHONE:
(562) 924-8718
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY: 136TOTAL ENROLLED CHILDREN: 108CENSUS: 85DATE:
04/12/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Mary NicholsTIME COMPLETED:
03:55 PM
NARRATIVE
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Licensing Program Analyst (LPA) T. Tran conducted an unannounced Case Management Incident visit at Kindercare Learning Center to follow up a self-reported incident occurred on 01/25/2023. The Monterey Park South West Office received the writing report on 01/26/2023. LPA met with center director, Mary Nichols and toured the facility. LPA observed proper care and supervision.

LPA completed child and staff’s files review. LPA obtained child's and staff document. Interviews were conducted with staff, child, and other. On the day of the incident, there were 16 children with two teachers. During naptime, staff observed child had difficulty breathing and attempted to wake child up. There were no health concerns in child’s record. Paramedic and parent was contacted. Based on the available information it does not appear this incident was the result of a Title 22 violation for Personal Rights.

No deficiency was cited at this time. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Mary Nichols.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Tiffanie Tran
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2023
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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