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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500377
Report Date: 04/15/2025
Date Signed: 04/15/2025 12:46:59 PM

Document Has Been Signed on 04/15/2025 12:46 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KIDS PLACE 2 EXPLORE & LEARN LLCFACILITY NUMBER:
394500377
ADMINISTRATOR/
DIRECTOR:		CARINA DIAZ DE BARAJASFACILITY TYPE:
850
ADDRESS:9371 N. LOWER SACRAMENTO ROADTELEPHONE:
(209) 478-6161
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 90TOTAL ENROLLED CHILDREN: 90CENSUS: 30DATE:
04/15/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:50 AM
MET WITH:Facilty Representative, Jocelyn AlvaradoTIME VISIT/
INSPECTION COMPLETED:
01:13 PM
NARRATIVE
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On April 15, 2025, Licensing Program Analyst (LPA) Elizabeth Santiago met with Facility Representative, Jocelyn Alvarado, to follow up on an Unusual Incident Report (UIR) that was reported to Community Care Licensing on 04/07/2025. Owner, Carina Diaz arrived during evaluation. 30 children were present and five staff members present during today’s inspection. LPA discussed with facility representative, through accessing Guardian, that all staff members present today were background cleared but a staff member were not associated to the license.

The facility reported the UIR to Community Care Licensing within 24hrs and submitted a written UIR within 7 days.

LPA interviewed the staff who were present during the incident and obtained information pertinent to the investigation. LPA reviewed and discussed this report with the facility representative.

Interview corroborated what was reported in the Unusual Incident Report (UIR) dated on April 7th, 2025: one (1) child (C1) opened the door to rainbow classroom and wandered away to the facility’s parking lot for approximately two (2) minutes during nap time, and stranger brought C1 back to C1’s childcare center, and teacher (T1) retrieved C1, which was absence of supervision and which poses an immediate health, safety, or personal rights risk to persons in care.

As a result of the absence of supervision, one (1) Type A violation was cited on a subsequent 809-D page and a Civil Penalty of five hundred dollars ($500) is being assessed.

In the areas that were evaluated, one type B deficiency was cited on subsequent LIC809D page.


Continues on LIC809-C......
NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Santiago
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/15/2025
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 4
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KIDS PLACE 2 EXPLORE & LEARN LLC
FACILITY NUMBER: 394500377
VISIT DATE: 04/15/2025
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........Continued from LIC-809........(Page 2)

LPA Santiago informed facility representative, Jocelyn, that this report dated 04/15/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.



Also, LPA Santiago informed the facility representative to provide a copy of this licensing report dated 04/15/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Facility evaluation report was reviewed and discussed with facility representative, Jocelyn Alvarado and Onwer, Carina Diaz. An exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
NAME OF LICENSING PROGRAM MANAGER: Chayntel Hunter
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Santiago
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/15/2025 12:46 PM - It Cannot Be Edited


Created By: Elizabeth Santiago On 04/15/2025 at 11:17 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KIDS PLACE 2 EXPLORE & LEARN LLC
FACILITY NUMBER: 394500377

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/15/2025
Section Cited
CCR
101229(a)(1)

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(a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, … Supervision shall include visual observation.
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Staff Meeting was held to focus on Supervision on which includes training on supervision. Facility represetantive will email LPA the sign-in sheet from this meeting that describes supervision policy and
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This requirement was not met as evidenced by: Based on record review and onsite staff interview, C1 wandered away from the classroom and was left unattended on the parking lot, resulting in an absence of supervision which poses an immediate risk to children in care.
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procedures will be expected of staff for the future. Facility represetative will email the signed statements to LPA by POC date.
Type B
05/15/2025
Section Cited
HSC101170(e)(1)

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(e) All individuals subject to a criminal record review... prior to working, residing or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department or
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Facility represetative will update facility roster for all employees associations to licenses by POC date.
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This requirement was not met as evidenced by: Based on record review record review, 2 staff members were not associated to license thorugh guardian.
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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.
Chayntel Hunter
NAME OF LICENSING PROGRAM MANAGER:
Elizabeth Santiago
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/15/2025


LIC809 (FAS) - (06/04)
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