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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001826
Report Date: 02/16/2021
Date Signed: 03/10/2021 10:51:53 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001826
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
840
ADDRESS:1101 ROSE DRIVETELEPHONE:
(707) 745-0916
CITY:BENICIASTATE: CAZIP CODE:
94510
CAPACITY:48CENSUS: 8DATE:
02/16/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Wendy Certeza - Center DirectorTIME COMPLETED:
11:00 AM
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A Tele-inspection was conducted today at 10:00:am, by Licensing Program Analyst (LPA) Melchisedeck Augustin and met with Center Director (CD), Wendy Certeza to obtain additional details surrounding an incident where staff (S1) reportedly spoke loud to a child (C1), grabbed C1’s arm; and put C1 in the Trouble Time Chair. The facility self-reported the incident and submitted an unusual incident report (UIR) on 02/08/21. During the tele-inspection, LPA interviewed S1, CD starting at 10:07am, and C1 was not available for an interview. CD and S1’s statements acknowledged that S1 held C1’s hand, however; S1 denied that she spoke loud to and/or forcefully grabbed C1’s hand and/or put C1 in a Troubled Time Chair; and S1 claimed she never violated any child’s personal rights. CD claimed she provided S1 with additional health and safety training which also includes methods on communicating with children.

Due to insufficient information available at this time, further investigation is warranted. CD’s signature was not recorded on this Facility Evaluation Report (FER), however; this FER was provided to CD, and CD’s confirmation of read receipt is on file.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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