376600311-6-18-2019-20-CC-MCUY-BDAUAW-20190619152526

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 376600311
Report Date: 06/18/2019
Date Signed: 06/18/2019 10:49:40 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/29/2019 and conducted by Evaluator Samantha Salunga

PUBLIC

COMPLAINT CONTROL NUMBER: 20-CC-20190329151856

FACILITY NAME:	KINDERCARE ROTHGARD - INFANT		FACILITY NUMBER:	376600311
ADMINISTRATOR:	RENAE STANSBERRY		FACILITY TYPE:	830
ADDRESS:	10130 ROTHGARD ROAD		TELEPHONE:	(619) 670-6566
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY:	23	CENSUS: 9	DATE:	06/18/2019
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Elle Jackson		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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9

Staff caused injury to daycare child.
Staff failed to provide adequate supervision resulted in injury.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Samantha Salunga and Leilani Curtis arrived at the facility to conduct an unannounced complaint inspection for the purpose of delivering the finding to the above allegations. Upon arrival, LPAs met with, Elle Jackson (Interim Director). There was a total of 9 children with three staff members (2 qualified teachers and 1 assistant). The initial complaint inspection was conducted on 04/03/19, when LPA Salunga conducted interviews with several staff and obtained/reviewed related documentation such as an updated children's roster, personnel files, ouch reports, and facility's Child Supervision Report (CSR). LPA Salunga subsequently interviewed several day care parents. During the course of the investigation, LPA Salunga received conflicting information regarding the above allegations. It cannot be determined whether staff failed to provide adequate supervision resulting in Child #1 sustaining an injury and whether staff caused an injury to Child #1. Based on the information gathered, the allegations are found to be unsubstantiated, which means that although the allegations may have happened or may be valid, there is not a preponderance of the evidence to prove the alleged violations occurred. No deficiencies are cited. The Notice of Site Visit (NOS) must be posted for 30 days. Due to printer malfunction, LPA Salunga will email and mail a copy of the NOS and appeal rights to Ms. Jackson. LPA reviewed this report with Ms. Jackson prior to obtaining her signature below.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Monica Cuddy	TELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha Salunga	TELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2019

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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