191204383-2-9-2022-30-CC-MRUZ-CBRV5W-20220218150835

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191204383
Report Date: 02/09/2022
Date Signed: 02/09/2022 02:36:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/29/2021 and conducted by Evaluator Antonio Almanza

PUBLIC

COMPLAINT CONTROL NUMBER: 30-CC-20211229090815

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	191204383
ADMINISTRATOR:	PAIGE MARTINEZ		FACILITY TYPE:	850
ADDRESS:	16901 LASSEN STREET		TELEPHONE:	(818) 368-5334
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	60	CENSUS: 52	DATE:	02/09/2022
		UNANNOUNCED	TIME BEGAN:	01:58 PM
MET WITH:	Director: Paige Martinez		TIME COMPLETED:	02:38 PM

ALLEGATION(S):

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Personal Rights: Facility is not following Covid-19 protocol.

INVESTIGATION FINDINGS:

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On 02/09/2022 at 1:58 p.m., Antonio Almanza, Licensing Program Analyst (LPA), conducted an unannounced site visit for the purpose of delivering findings for complaint received on 12/29/2021. LPA met with Paige Martinez, Director, and explained the purpose of the visit. During today’s visit there are 6 Adults providing care and supervision to 52 children in care.

During the course of the investigation, LPA Antonio Almanza conducted interviews and reviewed information regarding Allegation: (2) Facility is not following Covid-19 protocol.

Facility staff reported that they stopped checking and screening children for Coivd-19 Symptoms during drop off on September 13, 2021. Staff are reporting that they changed their entrance screening procedures per instructions from KinderCare Education Health and Safety department. During drop off, the facility implemented a Self-Attestation for parents to screen their own children prior to arriving to the facility or during drop off. pg 1 of 2

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 30-CC-20211229090815

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 191204383
	VISIT DATE: 02/09/2022

NARRATIVE

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Based on the evidence obtained, it was reviled that the facility is not following Covid-19 protocol during drop off. Based on LPAs interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. One Type B deficiency is being cited during today's visit (see LIC 809D), under California Code of Regulations, Title 22, Division 12, Chapter 1.

A copy of this Report (LIC9099), Notice of Site Visit, and Appeal Rights were explained and provided to the Director Paige Martinez.

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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 30-CC-20211229090815

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 191204383
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/09/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	101223 Personal Rights: (a)(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This Requirement is not met as evidenced by:	1 2 3 4 5 6 7	Director will adhere to Covid -19 protocol and make sure all children are screened by facility staff during drop off including taking childrens temperatures.
	8 9 10 11 12 13 14	Based on interviews, The Licensee did not make sure to conduct Coivd-19 Health screenings during drop off, which poses a potential Health or Safety, and personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
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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: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Antonio Almanza	TELEPHONE: (424) 301-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

LIC9099 (FAS) - (06/04)

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