Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406663
Report Date: 04/19/2018
Date Signed 04/19/2018 03:25:09 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
073406663
ADMINISTRATOR:KLOBERDANZ, JEANNIEFACILITY TYPE:
840
ADDRESS:6095 MAIN STREETTELEPHONE:
(925) 672-9370
CITY:CLAYTONSTATE: CAZIP CODE:
94517
CAPACITY:48CENSUS: 4DATE:
04/19/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Jeannie KloberdanzTIME COMPLETED:
03:40 PM
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Licensing Program Analyst Loretta Dyson met with Jeannie Kloberdanz for an unannounced random inspection. The center and playground were toured to conduct a health and safety inspection. There were 4 children and 2 staff present.

The school age component consists of two rooms. The floors, equipment, and surfaces appear to be safe, clean and in good repair. There is adequate furniture, toys and activities, which are age appropriate and in good condition. There is drinking water readily available to children. All sinks and toilets appear to be sanitary and in operating condition. There are no bodies of water, or free standing water, accessible to children. The food preparation area appears to be clean, free from litter and rodents, and food is stored properly. The playground has safe and age appropriate equipment, and all high climbing equipment and swings have sufficient cushioning underneath to absorb a fall. All required documents are posted for public review. Disaster drills are being conducted at least once every 6 months, and the log indicates the last one done was on 3/20/18. The center is equipped with fully stocked first aid kits, working telephone, carbon monoxide detectors, pull down fire alarms and fire extinguishers that are the appropriate size and fully charged. The center is providing 1% milk to children. LPA observed the interaction between the staff and children in care, and found it to be in compliance with the Title 22 Regulations.

The center roster was reviewed, and a copy was obtained. A review of children's and staff files was completed. All staff have been fingerprint cleared and associated to this center. All staff have provided proof of immunization against pertussis and measles, and provided a note declining the influenza immunization. At least one opening/closing staff member has a current CPR/First Aid certificate.

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SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2018
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073406663
VISIT DATE: 04/19/2018
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. A Plan of Operation, which includes IMS, has already been submitted to the Department and reviewed. 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: http://www.ada.gov/childqanda.htm. LPA verified that medications are current and stored properly.

Licensee is reminded that all staff must be fingerprint cleared prior to being in the presence of children in care, or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. The licensee was reminded of the responsibility as a mandated reporter.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates.

There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and appeal rights provided.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Loretta DysonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2018
LIC809 (FAS) - (06/04)
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