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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364846188
Report Date: 05/17/2022
Date Signed: 05/17/2022 12:10:01 PM

Document Has Been Signed on 05/17/2022 12:10 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:KIDDIE ACADEMY OF RANCHO CUCAMONGAFACILITY NUMBER:
364846188
ADMINISTRATOR:HEATHER JENKINSFACILITY TYPE:
850
ADDRESS:7220 VICTORIA PARK LANETELEPHONE:
(909) 891-8700
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91739
CAPACITY: 127TOTAL ENROLLED CHILDREN: 127CENSUS: 70DATE:
05/17/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:42 AM
MET WITH:Ashley Stuehrmann/Interim Director TIME COMPLETED:
12:45 PM
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On 5/17/2022 at 11:42 am , Licensing Program Analyst (LPA) Patricia Berry conducted a case management incident investigation. LPA was granted access into the facility and met with director. LPA took a census. LPA viewed video footage and interviewed staff..


Regarding an Unusual Incident Report, self reported by director to Community Care Licensing on 5/4/22. It was alleged a child pulled down another child's pants in the classroom while both children were looking out the window. Director stated the incident happened very fast. Director stated there was proper supervision. LPA observed from the video footage a child did pull down another child's pants, however; the teacher saw the incident occur and was walking toward the children when the incident was happening. The incident was about 4 seconds long.


Based on LPA's own observation of the video footage there does not appear to be a violation of Title 22 regulations at this time.

Exit interview with director, report, appeal rights and Notice of Site Visit provided to director.

LPA observed director post notice.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2022
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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