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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364809075
Report Date: 11/17/2021
Date Signed: 11/17/2021 10:42:07 AM

Document Has Been Signed on 11/17/2021 10:42 AM - 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:
364809075
ADMINISTRATOR:ALISA HOLTEGARRDFACILITY TYPE:
850
ADDRESS:960 W. BLOOMINGTONTELEPHONE:
(909) 877-3399
CITY:BLOOMINGTONSTATE: CAZIP CODE:
92316
CAPACITY: 104TOTAL ENROLLED CHILDREN: 36CENSUS: 32DATE:
11/17/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:ALISA HOLTEGARRDTIME COMPLETED:
11:00 AM
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On 11/17/2021 Licensing Program Analysts (LPAs) Giese and Zeigler conducted an unannounced visit to the facility to follow up on an Unusual Incident Report (UIR) that was submitted to the Regional Office on 10/29/21. LPAs met with Facility Director Alisa Holtegarrd to discuss the purpose of the visit. LPA took census, reviewed records, toured the facility and conducted interviews with staff.

UIR stated: On Monday 10/25/2021 staff noticed marks below the neckline of Child #1’s shirt and weren't sure if they were bruises or something else. Staff documented their observations and spoke to Child #1’s parent/guardian at pickup that same day. The following day, Tuesday 10/26/2021 a police officer came to the facility to inquire about the markings on Child #1’s neck. The officer informed Director and staff they had observed a photo of Child #1’s neck and would be reaching out to Child Protective Services (CPS). Child #1 did not attend the facility on 10/26/2021 or 10/27/2021.

Late evening on 10/27/2021 an individual came to the facility and identified themselves as the parent/guardian of Child #1. The individual stated the facility had injured Child #1 and requested to speak to the Director. The Assistant Director of the facility spoke to the individual regarding the facility’s observations and the discussion with the officer. The individual returned to their car and refused to leave the center. After a length of time the individual left. Director has made multiple attempts to contact the parent/guardians of Child #1 since this incident was documented, but has been unsuccessful. Child #1 has not returned to the center since last attending 10/25/2021.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE: DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/17/2021
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364809075
VISIT DATE: 11/17/2021
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LPA conducted interviews with Facility Director and Staff during the visit. Director and Staff interviews both corroborate information provided in the UIR. LPA was unable to interview Child #1 due to them not being present in the facility at the time of visit. Based on LPA's observations, interviews and information obtained during the visit, there appeared to be no violation of Title 22 Regulations pertaining to the reported incident.

An exit interview was conducted and LPAs reviewed this report with facility Director, Alisa Holtegarrd. A copy of this report and notice of site visit were provided. Notice of site visit must be displayed in a prominent location for the next 30 days.

No deficiencies were cited.

A copy of this report must be made available for the next three years.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC809 (FAS) - (06/04)
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