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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493001830
Report Date: 06/30/2021
Date Signed: 06/30/2021 02:06:28 PM

Document Has Been Signed on 06/30/2021 02:06 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
493001830
ADMINISTRATOR:RICHARDSON,KYLIEFACILITY TYPE:
830
ADDRESS:6150 STATE FARM DRIVETELEPHONE:
(707) 584-0124
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY: 32TOTAL ENROLLED CHILDREN: 0CENSUS: 23DATE:
06/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:38 AM
MET WITH:Kylie RichardsonTIME COMPLETED:
01:24 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Y. Yang. The facility file was reviewed prior to this visit. A review of the personnel report on file indicates that all facility staff have received criminal record and child abuse index clearances or exemptions. This is a combination center with a separate infant, preschool, and school age license. Operating hours are 07:00am-6:00pm, Monday-Friday.

The facility was toured inside and outside and the floor and yard plan were verified. The infants are physically separated from the preschool age and school age children in different classrooms. The facility was clean and orderly. The items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of reach of the children. The director stated there are no poisons stored on the premises and none were observed. The toys, floors and other equipment are clean, safe and age appropriate for infants. There was a crib available for each infant still napping in a crib. The changing table is sanitary and within arm's reach of a sink. A current menu was posted. Food prep areas are clean. Food is properly stored and refrigerated and labeled as needed. Garbage cans containing solid waste have tight fitting lids. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the facility. The playground is completely fenced and free of hazards. The infant playground has age appropriate equipment. There were no climbing structures observed that required fall cushioning. There were no bodies of water observed. The director stated no firearms are stored on site and none were observed. During today's visit staffing ratios were being met. Nine teachers were supervising 23 infants and toddlers. At least one staff member present possessed current CPR and First Aid certifications. Sign in/out procedure was reviewed and in compliance. Ten children's records were reviewed at 12:38pm. Children have current Needs and Services Plans and medical assessments in their files.

Continued on LIC 809-C
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 493001830
VISIT DATE: 06/30/2021
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This facility is currently providing Incidental Medical Services (IMS) children in care. The Department’s IMS policy was discussed with the Director. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices and COVID guidelines and best practices were reviewed and discussed with the Director. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
LIC809 (FAS) - (06/04)
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