343602990-4-14-2020-03-CC-BENN-BNRVUH-20200417164443

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343602990
Report Date: 04/14/2020
Date Signed: 04/14/2020 04:04:28 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/22/2020 and conducted by Evaluator Kelly Ferrara

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20200122112157

FACILITY NAME:	KINDERCARE LEARNING CENTER - LEXINGTON (SA)		FACILITY NUMBER:	343602990
ADMINISTRATOR:	JODY BRAUN DARONE		FACILITY TYPE:	840
ADDRESS:	295 S. LEXINGTON DRIVE		TELEPHONE:	(916) 983-6169
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	70	CENSUS: 19	DATE:	04/14/2020
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Jody Darone		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Lack of supervision resulted in day care child getting injured by another child while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Ferrara conducted a tele-inspection with Director Jody Darone to deliver complaint findings for the above allegation. Director stated that there are currently 19 school age children present with 3 staff.
It was alleged that Child #1 was injured by Child #2 while playing in the school age yard in the soccer area due to a lack of supervision by staff. During the investigation, LPA conducted interviews with reporting party, two staff, three parents, and Child #1. According to staff interviewed, Staff #1 was playing with the children and observed the entire situation and stated that Child #1 and Child #2 were playing tag and Child #1 fell to the ground after being tagged. Staff #1 stated that Child #1 did not come to them regarding the incident and did not appear upset. Staff stated that they did not see any apparent injuries on Child #1. Child #1 was interviewed and stated that Child #2 “body slammed” him, however the child made inconsistent statements regarding what that meant. During Child #1’s interview, the child demonstrated a body slam and was continuously moving and throwing himself onto the floor and couch which LPA determined that any injuries could have been self-inflicted. Child #1 made inconsistent statements regarding whether staff observed this alleged incident with Child #2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2020

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

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20200122112157

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - LEXINGTON (SA)	FACILITY NUMBER: 343602990
	VISIT DATE: 04/14/2020

NARRATIVE

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Due to inconsistent statements made during interviews, LPA Ferrara determined the allegation to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it. Title 22 Regulations section 101229 regarding staff responsibility for providing care and supervision was reviewed with the Director and an exit interview was conducted.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2020

LIC9099 (FAS) - (06/04)

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