073401902-6-30-2022-02-CC-SJON-CH6N7D-20220810101233

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073401902
Report Date: 06/30/2022
Date Signed: 06/30/2022 04:17:55 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/20/2022 and conducted by Evaluator Cherie Acosta

COMPLAINT CONTROL NUMBER: 02-CC-20220520081014

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	073401902
ADMINISTRATOR:	CHRISTINA RODRIGUEZ-PENA		FACILITY TYPE:	850
ADDRESS:	1285 MORELLO AVENUE		TELEPHONE:	(925) 372-7701
CITY:	MARTINEZ	STATE: CA	ZIP CODE:	94553
CAPACITY:	60	CENSUS: 34	DATE:	06/30/2022
		UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Christina Rodriguez-Pena		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff handled day care child roughly
Child received an injury while in care
Staff did not tell authorized representative of incident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced visit to deliver findings on the above allegations.

During the investigation LPA conducted interviews and obtained copies of documents. It is determined that a a staff handled a child roughly and caused the child to fall to the ground. As a result of the child falling on the concrete the child received scrapes. Staff failed to notify the child's parent on the incident. Staff involved in the incident no longer works at this facility.

Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 02-CC-20220520081014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 073401902
	VISIT DATE: 06/30/2022

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
26
27
28
29
30
31
32

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, 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 newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

Report reviewed with Christina Rodriguez-Pena
Notice of Site visit was provided and must be posted for 30 days.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 02-CC-20220520081014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: 073401902
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/30/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/01/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a	1 2 3 4 5 6 7	Following the incident director provided training to staff on personal rights of children. Director shall submit proof that all staff have received this training and submit proof to CCL by 7/1/22
	8 9 10 11 12 13 14	punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by: Child was handled roughly and was caused to receive an injury which poses an immediate risk to the health and safety of children in care	8 9 10 11 12 13 14	• 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.
Type B 07/08/2022 Section Cited CCR 101226(a)(2)	1 2 3 4 5 6 7	Health-Related Services. The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury... In the case of less serious injuries including, but not limited to, minor cuts, scratches and bites from other children requiring assessment and/or administration of first aid by staff,	1 2 3 4 5 6 7	Following the incident director has provided training to staff on reporting requirements. Director shall submit proof that all staff have received this training and submit proof to CCL by 7/8/22
	8 9 10 11 12 13 14	the licensee shall document the injury in the child's record and notify the child's authorized representative of the nature of the injury when the child is picked up from the center. This requirement was not met as evidenced by: Parent was not notified of incident where child was handled rough by staff and received an injury which poses a potential risk to the health and safety of children in care.	8 9 10 11 12 13 14	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.

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: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4