414004173-10-4-2022-05-CC-CINO-CK4UFX-20221011153328

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414004173
Report Date: 10/04/2022
Date Signed: 10/04/2022 02:38:56 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, 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
09/27/2022 and conducted by Evaluator Catrina Quimbo

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20220927131455

FACILITY NAME:	KINDERCARE LEARNING CENTER LLC (INF)		FACILITY NUMBER:	414004173
ADMINISTRATOR:	CHRISTY BERMUDEZ		FACILITY TYPE:	830
ADDRESS:	1350 WAYNE WAY		TELEPHONE:	(650) 577-0257
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	32	CENSUS: 30	DATE:	10/04/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Christy Michele Bermudez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff hit day-care child.

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

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 4

Control Number 05-CC-20220927131455

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: KINDERCARE LEARNING CENTER LLC (INF)	FACILITY NUMBER: 414004173
	VISIT DATE: 10/04/2022

NARRATIVE

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(Continued, Page 2...)

Based on LPA’s interviews and record review which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1, are being cited. Please refer to 9099D for more information.

Facility was issued a Type A citation for violation of children's personal rights.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Director was also provided copy of Appeal Rights and Procedures.

LPA Quimbo informed director, Christy Michele Bermudez, that this report dated October 4, 2022 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Quimbo informed the director, Christy Michele Bermudez, to provide a copy of this licensing report dated October 4, 2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with director, Christy Michele Bermudez.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 05-CC-20220927131455

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: KINDERCARE LEARNING CENTER LLC (INF)	FACILITY NUMBER: 414004173
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/04/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/04/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	101223 Personal Rights (a)(3) The licensee shall ensure that each child is...To be free from corporal or unusual punishment... This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director conducted internal investigation that included multiple staff interviews. Staff member that hit child was released from work at facility.
	8 9 10 11 12 13 14	Based on interviews and record review, a staff member hit an enrolled child while at facility.	8 9 10 11 12 13 14	Director is aware no staff member, under any circumstance, can place their hands on a child. Director conducted multiple staff meetings, reminding staff of personal rights.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

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
09/27/2022 and conducted by Evaluator Catrina Quimbo

COMPLAINT CONTROL NUMBER: 05-CC-20220927131455

FACILITY NAME:	KINDERCARE LEARNING CENTER LLC (INF)		FACILITY NUMBER:	414004173
ADMINISTRATOR:	CHRISTY BERMUDEZ		FACILITY TYPE:	830
ADDRESS:	1350 WAYNE WAY		TELEPHONE:	(650) 577-0257
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	32	CENSUS: 30	DATE:	10/04/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Christy Michele Bermudez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility did not report an incident to child's responsible party.

INVESTIGATION FINDINGS:

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On October 4, 2022 at approximately 1:00pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, complaint visit to Kindercare Learning Center LLC (INF). LPA met with director, Christy Michele Bermudez. The purpose of the visit was explained to director.

Facility is a combination center with a separate perschool and infant license. Under infant license, there are 30 children (under 24 months) and 8 staff members present.

On 09/15/2022, incident that involved a child at facility occurred. Director self reported incident to department 09/20/2022. The facility took action to conduct an internal investigation 09/16/2022 through 09/21/2022. Director gathered factual information and reported incident to child's responsible party.

Although the above allegation may have happened or is valid, based on LPA’s observations, interviews and record review which were conducted, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director, Christy Michele Bermudez.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

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

LIC9099 (FAS) - (06/04)

Page: 4 of 4