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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364809077
Report Date: 11/22/2023
Date Signed: 11/22/2023 02:52:48 PM

Document Has Been Signed on 11/22/2023 02:52 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:
364809077
ADMINISTRATOR:ALISA HOLTEGARRDFACILITY TYPE:
830
ADDRESS:960 W. BLOOMINGTONTELEPHONE:
(909) 877-3399
CITY:BLOOMINGTONSTATE: CAZIP CODE:
92316
CAPACITY: 23TOTAL ENROLLED CHILDREN: 23CENSUS: 14DATE:
11/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH: Assistant Director Melissa SpeakmanTIME COMPLETED:
03:10 PM
NARRATIVE
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On 11/22/23 at 11:10 a.m., Licensing Program Analyst (LPA) Blanca Ruiz arrived at the facility to conduct a Case Management inspection for the purpose of addressing a separate matter discovered during a complaint investigation. LPA met Assistant Director Melissa Speakman. During today’s inspection, the facility was toured, and census was taken. LPA verified teacher to child ratio and observed care and supervision to be in compliance with Title 22 regulation on 11/22/23. The facility serves infant children ages 6 weeks to 2 years old in Classrooms N.1 and N.2. This is a combination center, and other programs are preschool and school age. During inspection conducted on 09/21/23, Staff# 4 was observed providing care and supervision in the playground. Staff#4 stated that she has been working at the facility for 3 days. Staff was not associated to the facility.

Please see LIC 809D for cited deficiency of the California Code of Regulations, Title 22.


An exit interview conducted, and report was review with Assistant Director Melissa Speakman. A Notice of Site Visit and Type A Deficiency was given and must remain posted on, or immediately adjacent to the interior of the main door for 30 days. Appeal Rights discussed and given to facility representative, along with a copy of this report and LIC 9224 was given to the licensee or facility representative. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Upon receipt, the licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility for the next 12 months.


A copy of this report was provided to the Assistant Director on this date and must be made available to the public upon request for the next 3 years.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2023
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 11/22/2023 02:52 PM - It Cannot Be Edited


Created By: Blanca Ruiz-Silva On 11/22/2023 at 01:56 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: 364809077

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/22/2023
Section Cited
CCR
101170(e)(2)

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(2) Request a transfer of a criminal record clearance as specified in Section 101170(f). This requirement was not met as evidence by:
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Licensee understands that all staff should be fingerprinted and associated to the facility prior to allowing them to work directly with children. LIC 9182 was provided to the administrator during this inspection to be completed. Written statement of understanding was provided during inspection.
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LPA observed S4 providing care & supervision without Criminal Record Clearance associated to the facility.
Based on the interview/record review, S4 has been present at the facility 09/2023 without being properly associated to the facility/ No Criminal Record Clearance or Exemption was available for review for the above facility which poses an immediate Health, Safety & Personal Rights 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:Aaron Ross
LICENSING EVALUATOR NAME:Blanca Ruiz-Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2023


LIC809 (FAS) - (06/04)
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