<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804463
Report Date: 05/09/2023
Date Signed: 05/09/2023 01:59:04 PM

Document Has Been Signed on 05/09/2023 01:59 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804463
ADMINISTRATOR:TAHAN, JULIANAFACILITY TYPE:
830
ADDRESS:1609 CALVARY CIRCLETELEPHONE:
(909) 798-2987
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 17DATE:
05/09/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Director Juliana TahanTIME COMPLETED:
02:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 05/08/2023 LPA Susan Brewer, arrived at the facility unannounced for the purpose of conducting a case management inspection in response to the receipt of an unusual incident report (UIR), received on 04/13/2023. During the case management visit, LPA delivered an amended report and followed-up on a plan of correction. LPA was greeted by Juliana Tahan and granted entry to tour the facility. A census was taken of 17 children supervised by 6 staff. During today's visit, the following was discussed:

LPA S.Brewer, reviewed and delivered a copy of an amended report with director Juliana Tahan.

LPA reviewed pending plans of correction with director Juliana Tahan. Per director, proof of correction regarding staffing ratio and capacity will be submitted by close of business on 05/09/2023.

On 04/21/2023 LPA Susan Brewer, conducted an initial follow-up for the UIR by phone, which indicates that on 04/12/2023 a subject child tripped and fell, in the toddler classroom, causing an injury to the child's forehead, between the eyebrows. The LPA observed the area of the toddler classroom where the child was reported to have fallen. LPA inspected the wooden book shelf, reported as equipment that the child hit their head on. All furniture and equipment was observed to have rounded corners. LPA conducted an interview, which revealed that the subject child received stitches as result of the injury to the head and returned to the day-care the following day. Based on information gathered, it was determined that the incident was accidental. LPA confirmed that the facility acted appropriately and no violations have been identified. The facility staff applied 1st Aid to the subject child's injury and the authorized representative was notified of the incident by phone, then provided a written report upon pick up.

An exit interview was conducted and a copy of this report was provided to Director Juliana Tahan.

A notice of site visit was provided and must remain posted for 30 days.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2023
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 1