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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364804982
Report Date: 02/21/2025
Date Signed: 02/21/2025 12:38:10 PM

Document Has Been Signed on 02/21/2025 12:38 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804982
ADMINISTRATOR/
DIRECTOR:		CRYSTAL REYNOLDSFACILITY TYPE:
850
ADDRESS:13815 PEYTON DRTELEPHONE:
(909) 464-2255
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 56DATE:
02/21/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:03 AM
MET WITH:Crystal Reynolds, DirectorTIME VISIT/
INSPECTION COMPLETED:
12:47 PM
NARRATIVE
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A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. It was noted on January 29, 2025 a staff observed a child with one pill in his/her mouth. The staff immediately removed the intact pill, washed hands and notified Management. Management identified the pill as an Ibuprofen by the numbers on one side of the pill and notified the child’s Authorized Representative(s). Additionally, staff thoroughly checked all children’s pockets, mouths, cubbies, and teacher’s belongings which resulted in no other pills being found. The child did not have any side effects and outside medical attention was not received. During interviews it was disclosed the incident occurred in the opening classroom where there was high traffic. Staff are unaware how the child got the pill. Based on information gathered, the facility acted appropriately, however, a violation of the Title 22 regulation has been identified.

See LIC 809 D for deficiency

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Crystal Reynolds, Director.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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 02/21/2025 12:38 PM - It Cannot Be Edited

Citations on this Visit Report are Under Appeal!


Created By: Elyse Jones On 02/21/2025 at 10:58 AM
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: 364804982

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
02/24/2025
Section Cited
CCR
101223(a)(2)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by: Based on the observation, interview and
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The Director understands hazardous items must be free of and/or inaccessible to the children in care. Director agrees to write a statement of understanding of the regulation and a plan to ensure an incident like this does not happen in the future. Statement and plan are due on or by 2-24-2025.
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record review, the Licensee did not meet the above regulation which poses an immediate health risk to the children in care. The facility self reported a child being observed with one Ibuprofen pill in his/her mouth. During interviews staff disclosed they are unaware how the child got the pill.
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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:Aaron Ross
LICENSING EVALUATOR NAME:Elyse Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2025


LIC809 (FAS) - (06/04)
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