483001825-9-20-2022-01-CC-AHON-CJMP3G-20220926105728

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483001825
Report Date: 09/16/2022
Date Signed: 09/20/2022 08:33:16 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/18/2022 and conducted by Evaluator Mary Trinh

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220718154747

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	483001825
ADMINISTRATOR:	ERIKA RAMIREZ		FACILITY TYPE:	850
ADDRESS:	1101 ROSE DRIVE		TELEPHONE:	(707) 745-0916
CITY:	BENICIA	STATE: CA	ZIP CODE:	94510
CAPACITY:	72	CENSUS: 37	DATE:	09/16/2022
		UNANNOUNCED	TIME BEGAN:	02:02 PM
MET WITH:	Erika Silva, Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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9

Administrator did not prevent the spread of COVID-19.

INVESTIGATION FINDINGS:

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Licensing Program Analyst, (LPA) Mary Trinh met with Director, Erika Silva (D1) to deliver complaint finding. It has been alleged that Administrator did not prevent the spread of COVID-19.
On 07/25/2022 at 12:00 pm, LPA Trinh interviewed D1 who explained that when there are any positive Covid cases, all parents and staff are notified by letter (for staff) and KLC App (for parents). Staff are expected to clean and wipe down surfaces and toys after a Covid outbreak. On 07/25/2022, LPA Trinh interviewed Staff 2 (S2) at 12:50 pm and Staff 3 (S3) at 1:40 pm. S2 and S3 stated that after a Covid outbreak all parents and staff are notified. Staff are supposed to clean surfaces and toys after Covid outbreak.
This agency has investigated the complaint alleging that Administrator did not prevent the spread of COVID-19. We have found that the allegation is Unsubstantiated. Based on the information gathered during this investigation, there is insufficient information to prove or disprove the allegations as reported. There is not a preponderance of the evidence to prove the allegation, therefore the finding are determined to be Unsubstantiated.
Appeal rights printed and given to Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/18/2022 and conducted by Evaluator Mary Trinh

COMPLAINT CONTROL NUMBER: 01-CC-20220718154747

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	483001825
ADMINISTRATOR:	ERIKA RAMIREZ		FACILITY TYPE:	850
ADDRESS:	1101 ROSE DRIVE		TELEPHONE:	(707) 745-0916
CITY:	BENICIA	STATE: CA	ZIP CODE:	94510
CAPACITY:	72	CENSUS: 37	DATE:	09/16/2022
		UNANNOUNCED	TIME BEGAN:	02:02 PM
MET WITH:	Erika Silva, Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
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3
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5
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8
9

Staff did not observe a Child wondered away from playground.
Facility is not reporting unusual incidents to CCL.

INVESTIGATION FINDINGS:

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Licensing Program Analyst, (LPA) Mary Trinh met with Director, Erika Silva (D1) to deliver complaint finding. It has been alleged that Staff did not observe a Child wondered away from playground.
The incident where staff did not observe a Child wondered away from playground occurred on 07/12/2022, specically that C1 wondered away in playground and attempted to go inside the classroom. Staff 3 (S3) was interviewed on 09/16/2022 at 1:15 pm and 07/25/2022 at 1:40 pm regarding the incident. Staff 2 (S2) was interviewed on 07/25/2022 at 12:50 pm regarding the incident. S2 and S3 did not observe C1 to have wondered away from playground.
On 07/25/2022, D1 stated that Unusual Incident Report (UIR) for incident that occurred on 07/12/2022 was mailed to Licensing. LPA Trinh did not receive a copy of the UIR dated on 07/12/2022. D1 did not have a copy of the the UIR dated on 07/12/2022. (See amended LIC 9099D)
Based on the information gathered during this investigation, there is a preponderance of evidence to prove that the above allegations did occur. The allegations are determined to be Substantiated. Appeal Rights printed and given to Director.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

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 01-CC-20220718154747

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 483001825
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/16/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 09/16/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision. No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.	1 2 3 4 5 6 7	1. Director will have all staff meeting about procedures and policies of Supervision 09/21/2022. 2. Inform all Parents of what happened.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: On UIR of 07/12/2022, S2 and S3 did not observe that C1 wondered away from the playground and attempted to run inside the classroom. This presents a potential threat to the health and safety of children in care.	8 9 10 11 12 13 14	Notes of the staff meeting will be emailed to LPA Trinh by 09/21/2022. mary.trinh@dss.ca.gov
Type B 09/16/2022 Section Cited CCR 101212(d)(1)(C)	1 2 3 4 5 6 7	(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. (1) Events reported shall include the following: (C) Any unusual incident or child absence that threatens the physical or emotional health or safety of any child.	1 2 3 4 5 6 7	Director will always email to CCL UIR's and not through post office mail. CCL email is: cclrpregionalofficegeneral@dss.ca .gov
	8 9 10 11 12 13 14	UIR occurred on 07/12/2022 and UIR was received to CCL on 08/03/2022. This poses a potential safety to the children in care,	8 9 10 11 12 13 14

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: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 09/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2022

LIC9099 (FAS) - (06/04)

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