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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455403967
Report Date: 06/29/2021
Date Signed: 07/01/2021 09:45:44 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/01/2021 and conducted by Evaluator Jaime Snow
COMPLAINT CONTROL NUMBER: 13-CC-20210401152241
FACILITY NAME:KINDERLAND CHILD DEVELOPMENT CENTERFACILITY NUMBER:
455403967
ADMINISTRATOR:WILSON, SUSANFACILITY TYPE:
830
ADDRESS:1630 VICTORTELEPHONE:
(530) 223-6161
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:36CENSUS: 11DATE:
06/29/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Eilene Vaughn TIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Supervision: Child was injured while in care.
Staff not communicating with authorized representative.
Child is being left in soiled diapers.
INVESTIGATION FINDINGS:
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On June 29, 221 at 10:30AM, Licensing Program Analyst (LPA) Snow conducted an unannounced complaint inspection, and met with licensee, Susan Wilson. The LPA observed 3 staff watching 11 infants upon arrival. It was alleged that there was a lack of supervision that lead to a child being injured while in care; specifically that Staff (S1) placed Child (C1) in a short wooden chair and C1 fell off and hitting her head and leaving a significant bruise/goose egg. The LPA Spoke with S1 who does not recall the incident. The director did not have knowledge of the incident but denied any lack of supervision and provided photos of the highchairs & short wooden chairs they have at the facility. The LPA received the internal incident report from March 30th, 2021, which stated that C1’s head hit the tile floor and the child was placed back in the chair after getting “ice, rest & TLC”. continued (amended on 6/30/21)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
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 5
Control Number 13-CC-20210401152241
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KINDERLAND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 455403967
VISIT DATE: 06/29/2021
NARRATIVE
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 The parent and two other witnesses report that C1, who is an infant, was unable to sit up for feedings and should have been in the highchair. The LPA received photos taken the same day as the fall showing a large swollen discolored area on C1’s forehead. 12 interviews were conducted with parents and staff; 3 confirmed the child’s inability to sit unassisted and the internal incident report confirms C1 was placed back in the chair after the fall. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation that a lack of supervision lead to a child being injured is found to be substantiated.

It was also alleged that staff not communicating with authorized representative; specify that a parent was not informed when C1 fell on the tile resulting in a bruise and swelling on the forehead. The LPA received the internal incident report from March 30th, 2021, which confirms that the parent was not called after C1 hit her head on the tile. The LPA also received a photo of the injury taken on the same day as the incident. The director and the 7 staff who were interviewed all confirmed that it is policy to inform a parent of anytime a child hits their head. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation that a staff not communicating with authorized representative is found to be substantiated.

It was also alleged that children are being left in soiled diapers. The Director, Susan Wilson denied this. She said it is their policy to check & change diapers at least every 2 hours. The LPA interviewed 12 witnesses (parents and staff) and 5 confirmed the allegation stating some form of the following; dried feces, feces on leg, staff asks if I want the soiled diaper changed when I get there, increased rashes in number and severity. A witness also said the paperwork provided by the facility at the end of the day sometimes shows 3 to 4 hours between changes. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation that children are left in soiled diapers is found to be substantiated. continued * Report amended 6/30/21.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 13-CC-20210401152241
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KINDERLAND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 455403967
VISIT DATE: 06/29/2021
NARRATIVE
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TYPE A The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

Notice of Site Visit shall be posted for 30 days from today’s visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 13-CC-20210401152241
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KINDERLAND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 455403967
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
07/02/2021
Section Cited
CCR
101427(i)
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Infant Care Food Service:
High chairs or other appropriate seating equipment shall be used to seat infants during feeding. Infants who are unable to sit unassisted in a high chair or other seating equipment shall be held by a staff person or other adult for feeding.
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Additional training for Staff (S1) concerning the abilities of children in developmental stages and precautions that should be taken. Please provide proof of relevant training by 7/16/21
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 Was not met as evidenced by: C-1 was placed in a small wooden chair when she was unable to hold herself up and fell and hit her head on the tile floor and was placed back in the same chair. Based on internal incident report and witness interviews. Which posed a Health and Safety risk to children in care.
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Send the plan of how you will accomplish this training due July 2, 2021.
Immediately all authorized representative enrolled in the infant program must be provided this report and a signed LIC 9224 form is required in each file for the next 12 months. *Report amended on 6/30/21
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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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 13-CC-20210401152241
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KINDERLAND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 455403967
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2021
Section Cited
CCR
101428(b1)(b2)
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Infant Care Personal Services: The infant care center shall ensure that the infant has sufficient changes of clothing and diapers so that his/her clothing and diapers can be clean and dry at all time & each infant's clothing and diapers shall be changed as often as necessary to ensure that the infant is clean and dry at all times.
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Provide proof of additional staff training (for all staff that change diapers) on diaper changes and rashes by 7/16/21.
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Was not met based on witness statements, children not being clean and dry at pickup and an increase in rashes. Based on parent and staff interviews. Which posed a potential Health and Safety risk to children in care.
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Type B
06/29/2021
Section Cited
CCR
101212(d)(1)(C)(f)
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Reporting Requirements Events reported shall include any unusual incident or child absence that threatens the physical or emotional health or safety of any child & shall also be reported to the child's authorized representative.
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Provide proof of additional staff training for all staff regarding equipment to report incidents to Community care licensing and the authorized representative.
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As evidenced by no notification to CCL and the parent was not called. Based on parent interview and documentation Which posed a potential Health and Safety risk to children in care.
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 And training on how to respond to injuries that are potentially serious.
Send proof of the training by 7/29/21

*report amended 6/30/21
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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5