Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197403594
Report Date: 07/10/2015 12:00:00 AM
Date Signed 07/10/2015 04:54:31 PM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
197403594
ADMINISTRATOR:ANA CASTELLANOSFACILITY TYPE:
830
ADDRESS:17730 RINALDITELEPHONE:
(818) 363-8442
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:24CENSUS: 15DATE:
07/10/2015
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Thania Garcia, Assistant directorTIME COMPLETED:
04:53 PM
NARRATIVE
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Licensing Program Analyst (LPA) Khadarian conducted an unannounced site visit. Health and Safety Compliance visit was conducted to the facility for the Military Facility Project. The licensee reported that there is one child from military family being served in the facility. LPA was guided on a tour of the facility inside and outside. The director arrived during the visit. The following was observed/discussed:

1. Teacher to child ratio;
2. Fingerprint clearance of staff;
3. Care and supervision of children in care; teacher/child interaction;
4. Availability of drinking water to children both indoors and outdoor. Children have drinking water fountains indoors; water is made available outdoors in pitchers
5. Cleanliness of facility and children's toys/equipment; cushioning under outdoor equipment. The outdoor activity space surfaces are free of hazards.
6. Cleanliness of bathrooms, operation of toilets and sinks.
7. Inaccessibility of chemicals and toxins to children in care;
8. Playground equipment was observed to be in good condition, free of sharp, loose or pointed parts.
9. Quality and quantity of snacks and food for the number of children currently enrolled; storage of food supplies, posting of menus and accuracy. Storage of snacks. The school serves breakfast, mid-morning snacks, lunch and mid-afternoon snacks.
10. Allergy list is posted in each classroom and on the kitchen refrigerator. Medication is stored in locked cabinet in the kitchen.
11. Sign in/out sheets; postings; emergency disaster drill logs.
12. Napping equipment and storage of children's belongings. Napping mats were observed. Sheets and blankets are stored in the children's cubbies.
SUPERVISOR'S NAME: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Shoghig KhadarianTELEPHONE: (310) 337-4308
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2015
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


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403594
VISIT DATE: 07/10/2015
NARRATIVE
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13. The director has current Pediatric CPR/1st aid training to expire in June 2016. Per licensee, all staff staff are trained, but the expiration dates vary.
14. There are no bodies of water on the premises.
15. There are no firearms or poisons, per licensee. None were observed
16. Infant changing tables have padding surface and raised sides.
17. The infant indoor and outdoor activity spaces are separate from the other programs.
18. Sample of children's files were reviewed for accuracy and completeness. the infant files include individual needs and services plan signed.
17. Sample of staff files were reviewed to include the education and /or experience required.
18. Movable bins have tight fitting covers.
19. The licensee was recommended to access information about Licensing and recent regulatory changes from the Licensing website at ccld.ca.gov and specifically the Manual Update. The licensee was advised to use the new complaint phone number on parent's rights poster to be 1-844-538-8766.

The facility was cited under Title 22 Regulation Requirements.

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 in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee shall maintain records (LIC 9224) that they complied with this requirement.

Copy of the report was provided. Exit interview.
SUPERVISOR'S NAME: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Shoghig KhadarianTELEPHONE: (310) 337-4308
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2015
LIC809 (FAS) - (06/04)
Page: 2 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403594
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/10/2015
Section Cited
101170(e)(3)
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Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall request a transfer of a criminal record clearance from another facility or Trustline.Teacher Irma Romo has been working since 6/1/15 is cleared but not associated
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The licensee shall immediately request the transfer of the clearance of these staff to this facilty, retain copies of records and have the staff return to work after they have been associated to the facility.
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to this facility. This is a type A violation.
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Type A
07/10/2015
Section Cited
101195(b)
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Penalties: Notwithstanding Section 101195(a) above, an immediate penalty of $100 per cited violation per day for a maximum of five (5) days shall be assessed if any individual required to be fingerprinted or not obtained a California clearance or criminal record exemption, requested a transfer of a criminal record
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$500 civil penalty will be assessed for failing to associate IIrma Romoto this facility or for producing proof of requesting the transfer. Penalties are due immediately upon receipt of the statement.
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clearance or requested and be approve for a transfer of an exemption as specified in Section 101170(e) prior to working, residing or volunteering in the facility.
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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: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Shoghig KhadarianTELEPHONE: (310) 337-4308
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2015
LIC809 (FAS) - (06/04)
Page: 3 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6167 BRISTOL PARKWAY #400
CULVER CITY, CA 90230
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 197403594
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2015
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/24/2015
Section Cited
101217(a)
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Personnel Records. Personnel records shall be maintained on the licensee, administrator, and each employee, and shall contain specified information. Review of records for employee Irma Romo revealed the required licensing forms were missing, including but not limited to personnel record, emplolyee rights,
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Licensee shall complete and maintain complete records for each employee.
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criminal record statement, etc.
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Type B
07/24/2015
Section Cited
101419.3(a)
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Modications to infant needs and services plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Review of children # 1 and 2's files revealed the plan was last evaluated on 3/30/15 and is in need of review.
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The licensee agrees to update the records as necessary and maintain a system to ensure compliance at all times.
Type B
07/24/2015
Section Cited
101416.2
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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: Bill MayedaTELEPHONE: (310) 337-4341
LICENSING EVALUATOR NAME: Shoghig KhadarianTELEPHONE: (310) 337-4308
LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2015
LIC809 (FAS) - (06/04)
Page: 4 of 4