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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343603025
Report Date: 08/05/2021
Date Signed: 08/05/2021 02:01:47 PM

Document Has Been Signed on 08/05/2021 02:01 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - SAN JUAN (PRESCHOOL)FACILITY NUMBER:
343603025
ADMINISTRATOR:ALLRED, DAWNAFACILITY TYPE:
850
ADDRESS:5448 SAN JUAN AVENUETELEPHONE:
(916) 961-5599
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 92TOTAL ENROLLED CHILDREN: 0CENSUS: 59DATE:
08/05/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Dawna AllredTIME COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility for an unannounced Case Management inspection. Upon arrival LPA observed 59 children with seven teachers. During the inspection LPA conducted interviews and gathered documents revealing that Staff# 1 handled Child# 1 in rough manner by pulling the child off a bicycle and speaking to the child in an inappropriate tone. This is considered as an immediate risk to the children in care. Dawna stated that they have done a full investigation and has done trainings with staff revolving the incident. Title 22 deficiencies are cited on the subsequent page of this report. Type Acknowledgement forms are to be signed by current parent of the facility and new parents for the next twelve months. LIC 9224 and Appeal Rights were provided. An exit interview was conducted and a Notice of Site Visit posted which must remain posted for 30 days.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2021
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 08/05/2021 02:01 PM - It Cannot Be Edited


Created By: Christopher Bello On 08/05/2021 at 01:31 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - SAN JUAN (PRESCHOOL)
FACILITY NUMBER: 343603025

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/05/2021
Section Cited
CCR
101223(a)(3)

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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or
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Dawna stated that they have conducted trainings revolving around the incident so that it does not occur again.

LPA cleared the deficiency.
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withholding of shelter, clothing, medication or aids to physical functioning. This requirement has not been met by evidence: Staff#1 handled a child roughly and spoke to a child in a innappropriate tone. This is considered as an immediate risk to the 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:Roxana Saravia
LICENSING EVALUATOR NAME:Christopher Bello
LICENSING EVALUATOR SIGNATURE:
DATE: 08/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/05/2021


LIC809 (FAS) - (06/04)
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