<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343602989
Report Date: 09/26/2024
Date Signed: 09/26/2024 11:44:43 AM

Document Has Been Signed on 09/26/2024 11:44 AM - 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KINDERCARE LEARNING CENTER - LEXINGTON (INF)FACILITY NUMBER:
343602989
ADMINISTRATOR/
DIRECTOR:		STRIBIK, JESSICAFACILITY TYPE:
830
ADDRESS:295 S. LEXINGTON DRIVETELEPHONE:
(916) 983-6169
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 16DATE:
09/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Jessica StribikTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Jennifer Velasco met with Facility Representative, Director Jessica Stribik (Representative), for the purpose of an unannounced Case Management inspection. On 09/18/2024, Representative submitted an Unusual Incident Report (UIR) that states on 09/16/2024, eight infants were in an infant classroom that was briefly out of ratio when a staff (Staff1) left the classroom with a basket of laundry, leaving another staff (Staff2) alone with the eight infants. UIR also states during the time Staff1 was gone, Staff2 propped open a connecting door and exited the classroom to retrieve a blanket that had been left in another Infant classroom and took it to the laundry room, where Staff1 already was, briefly leaving eight infants without any supervision. A teacher in the other infant classroom, Staff3, noticed the infants were unattended and stood in the connecting doorway until Staff1 and Staff2 returned. LPA conducted interviews with multiple staff and reviewed facility documentation of the incident. Staff statements and facility documentation indicated the room was out of ratio for one minute and infants were without supervision for a few to several seconds.

Representative was informed that this report, dated 09/26/2024, documents two Type A citations and must be posted for 30 consecutive days. Representative must also provide a copy of this licensing report 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. Because one citation involved an absence of supervision, an immediate civil penalty of $500 has been issued. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted and this report was reviewed with Representative, Director Jessica Stribik. Appeal rights were provided. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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 2
Document Has Been Signed on 09/26/2024 11:44 AM - It Cannot Be Edited


Created By: Jennifer Velasco On 09/26/2024 at 09:43 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: KINDERCARE LEARNING CENTER - LEXINGTON (INF)
FACILITY NUMBER: 343602989

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/27/2024
Section Cited
CCR
101429(a)(1)

1
2
3
4
5
6
7
(a) In addition to Section 101229, the following shall apply: (1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement was not met as evidenced by witness
1
2
3
4
5
6
7
Facility representative stated they will develop a detailed written plan for providing staff with one-on-one training and a review of practices to prevent future absence of supervision incidents. One staff's employment has been terminated, and another staff was placed on administrative leave.
8
9
10
11
12
13
14
statements and facility documentation that during this self-reported incident eight infants were briefly left without supervision, which constitutes an absence of supervision. This poses an immediate health, safety, and/or personal rights risk to infants in care.
8
9
10
11
12
13
14
 Facility representative stated they will email this plan and training materials to LPA by close of business POC due date.

[email protected]
Type A
09/27/2024
Section Cited
CCR101416.5(b)

1
2
3
4
5
6
7
(b)There shall be a ratio of one teacher for every four infants in attendance. This requirement was not met as evidenced by witness statements and facility documentation that during this self-reported incident eight infants were briefly
1
2
3
4
5
6
7
Facility representative stated they will develop a detailed written plan for providing staff with one-on-one training and a review of practices to prevent future ratio incidents. One staff's employment has been terminated, and another staff was placed on administrative leave.
8
9
10
11
12
13
14
left in the care of one staff, which means the room was out of ratio. This poses an immediate health, safety, and/or personal rights risk to infants in care.
8
9
10
11
12
13
14
Facility representative stated they will email this plan and training materials to LPA by close of business POC due date.

[email protected]
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:Natalie Dunaway
LICENSING EVALUATOR NAME:Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2