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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334805786
Report Date: 07/28/2021
Date Signed: 07/28/2021 03:08:53 PM

Document Has Been Signed on 07/28/2021 03:08 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334805786
ADMINISTRATOR:EVA HERNANDEZFACILITY TYPE:
850
ADDRESS:7920 LIMONITE AVENUE, SUITE GTELEPHONE:
(951) 681-1440
CITY:RIVERSIDESTATE: CAZIP CODE:
92509
CAPACITY: 67TOTAL ENROLLED CHILDREN: 0CENSUS: 22DATE:
07/28/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Daniela NavaTIME COMPLETED:
03:25 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Taadhimeka Zeigler and Justin Giese arrived at the facility on date and time listed. A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 06/17/2021. It indicates that on 06/14/2021, child #1 ran out of the classroom into the breezeway, but still behind the gate, unsupervised. Child #1 was intercepted by staff in the front office.

During today’s inspection, LPAs reviewed the files for staff #1 and child #1. LPAs also interviewed the Asst. Director, Daniela Nava. After the incident occurred, the facility placed staff #1 on administrative leave and conducted their own investigation resulting in the termination of staff #1.

Based on the information gathered, the following violation has been identified:

See LIC809D for cited deficiencies.

101229(a)(1) Responsibility for Providing Care and Supervision

The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.



An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to facility staff.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Taadhimeka Zeigler
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 07/28/2021 03:08 PM - It Cannot Be Edited


Created By: Taadhimeka Zeigler On 07/28/2021 at 02:30 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334805786

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2021
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision - The licensee shall provide care and supervision as necessary to meet the children's needs. No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual observation.
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Staff #1 was terminated. During a staff meeting on 06/25/2021, responsibility for providing care and supervision was discussed. In addition, all staff will be re-trained on responsibility for providing care and supervision. Proof will be submitted to CCL by POC due date.
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This requirement has not been met as evidenced by: On 06/14/2021, C1 ran out of the classroom into the breezeway, but still behind the gate, unsupervised. Child was intercepted by staff in the front office. This poses an immediate risk to the health and safety 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:Kimberly Williams
LICENSING EVALUATOR NAME:Taadhimeka Zeigler
LICENSING EVALUATOR SIGNATURE:
DATE: 07/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/28/2021


LIC809 (FAS) - (06/04)
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