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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073402043
Report Date: 08/06/2026
Date Signed: 08/06/2026 04:44:39 PM

Document Has Been Signed on 08/06/2026 04:44 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
073402043
ADMINISTRATOR/
DIRECTOR:		KLOBERDANZ, JEANNIEFACILITY TYPE:
830
ADDRESS:6095 MAIN STREETTELEPHONE:
(925) 672-9370
CITY:CLAYTONSTATE: CAZIP CODE:
94517
CAPACITY: 28TOTAL ENROLLED CHILDREN: 25CENSUS: 15DATE:
08/06/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Ashley Van LaarTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 8/6/2026 Licensing Program Analyst (LPA) Kayla Merchant conducted a Case Management - Incident inspection for a self reported incident involving an infant child.

On 7/30/2026 at 10:29 AM, a child was placed in their crib for a nap. At 11:21 AM, the child woke up from their nap, they saw one of the teachers and lean on the side of the crib that has a hinged flap that locks. When the child leaned onto the flap, it flipped down causing them to fall to the ground before the teacher could grab them. The floor is a hard wooden surface with no cushioning. The child did not have any bumps or bleeding, but there were scratches and a red mark on their forehead from the fall. Two staff members were in the class when the incident occurred. After investigating, the director concluded that the flap was up but the latch was not properly secured by the staff member that put the child down for the nap.

This incident posed an immediate risk to the Health, Safety or Personal Rights to the child in care. Therefore a Type A violation is cited today, California Code of Regulations, Title 22, Division 12 on 809-D page.

LPA Kayla Merchant informed Director, Ashley Van Laar, that this report dated 8/6/2026 document 1 Type A citation which shall be posted for 30 consecutive days as there was immediate risk(s) to the health, safety, or personal rights of children in care. Also, LPA Kayla Merchant informed the director to provide a copy of this licensing report dated 8/6/2026 that documents any Type A citation 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.

Sherelle Johnson
Kayla Merchant
DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2026
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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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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Document Has Been Signed on 08/06/2026 04:44 PM - It Cannot Be Edited


Created By: Kayla Merchant On 08/06/2026 at 04:15 PM
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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 073402043

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2026
Section Cited
CCR
101223(a)(2)

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101223(a)The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by:
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The staff member that did not lock the flap into place was place on admin leave and director conducted a training with the infant/toddler teachers covering safe sleep practices and implented a 2 person check system to ensure that all crib flaps are locked into place once a child is placed into the crib. The training sign in sheet was provided to the LPA and the deficiency is cleared as of 8/6/2026.
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A child fell out of the crib due to the crib flab not being locked into place which posed an immediate risk to the Health, Safety or Personal Rights to the child in care.
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Failure to correct will result in a $100 per day civil penalty until corrected.
Repeat violations are $250 per violation and $100 per day until corrected

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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.
Sherelle Johnson
NAME OF LICENSING PROGRAM MANAGER:
Kayla Merchant
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/06/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2026


LIC809 (FAS) - (06/04)
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