414001398-6-1-2021-05-CC-GLEG-C3TV6Y-20210609161015

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414001398
Report Date: 05/20/2021
Date Signed: 06/01/2021 04:37:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/26/2021 and conducted by Evaluator April Cowan

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210426160759

FACILITY NAME:	KINDERCARE LEARNING CENTER LLC (PS)		FACILITY NUMBER:	414001398
ADMINISTRATOR:	SCHMALZ, DINA (MIMI)		FACILITY TYPE:	850
ADDRESS:	1350 WAYNE WAY		TELEPHONE:	(650) 577-0257
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	70	CENSUS:	DATE:	05/20/2021
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Dina Schmalz		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff did not provide the needs of day-care child after an injury

Facility did not follow injury protocol for injured child in care

INVESTIGATION FINDINGS:

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THIS IS AN AMENDED REPORT

On 5/20/19 at 2:30 PM, Licensing Program Analyst (LPA) Cowan met with site director for an unannounced subsequent complaint inspection. The purpose of the inspection was to deliver findings, and the purpose of the inspection was explained. Due to Covid-19 State Emergency, the inspection is conducted via telephone call.

During the course of investigation, interviews were conducted with director and staff, and records were reviewed. There was no proof that care was provided for injured child. The facility failed to deliver an incident report to the parents that describes the care of the injured child.

Based on interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegations are founded to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.

This report is emailed to director with a request for reply demonstrating receipt.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021

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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