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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197405917
Report Date: 11/02/2022
Date Signed: 11/02/2022 04:03:36 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, 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
10/26/2022 and conducted by Evaluator Lillian J Casillas
PUBLIC
COMPLAINT CONTROL NUMBER: 30-CC-20221026133031
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
197405917
ADMINISTRATOR:DEMI LARAFACILITY TYPE:
830
ADDRESS:1520 GREENWOOD AVENUETELEPHONE:
(310) 320-4429
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:16CENSUS: 12DATE:
11/02/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Monica GonzalezTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Physical Plant: Daycare child sustained an injury in care of the facility.
INVESTIGATION FINDINGS:
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On 11/02/2022, Licensing Program Analyst (LPA) Lillian Casillas conducted an unannounced complaint investigation for the allegation above. LPA met with Director, Monica Gonzalez. LPA observed 12 infants with 4 teachers.

During today's visit, LPA interviewed Director and 6 staff. LPA also obtained copies of the Parent Handbook section about "Child Accidents" and the LIC 624 Incident Report submitted to the Department on 11/01/2022. LPA requested scans of the files for all children currently enrolled.

Based on interviews, observation, and record review, there a preponderance of evidence to prove the alleged violation did occur. While the incdent was accidental and unintentional, Child 1 sustained an injury to the face. Therefore, the allegation is SUBSTANTIATED. A Type B deficiency was cited during today's inspection (see LIC 9099-D for details).

[CONTINUE ON PAGE 2]
Substantiated
Estimated Days of Completion: 0
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
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-20221026133031
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: 197405917
VISIT DATE: 11/02/2022
NARRATIVE
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PAGE 2

An exit interview was conducted and a copy of this report along with the Notice of Site Visit and Appeal Rights were provided to Director, Monica Gonzalez.
SUPERVISOR'S NAME: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 30-CC-20221026133031
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: 197405917
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/02/2022
Section Cited
CCR
101238.3(b)
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101238.3 Indoor Activity Space

(b) The floors of all rooms shall have a surface that is safe and clean.

This requirement was not met as evidencedy by:
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Director removed the all area mats from the classroom during the inspection.
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Based on interviews, record review, and obervation, Director did not ensure safe flooring in the classroom as Staff 7 tripped on an area mat, fell, and dropped Child 1 (C1) on, which poses a potential health, safety, or personal rights risk to children in care. In this incident, C1's lip was injured.
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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: Maureen NealTELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J CasillasTELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3