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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001828
Report Date: 12/13/2023
Date Signed: 12/13/2023 05:48:12 PM


Document Has Been Signed on 12/13/2023 05:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 CENTERFACILITY NUMBER:
483001828
ADMINISTRATOR:HAYMER, MORNENFACILITY TYPE:
850
ADDRESS:581 PEABODY ROADTELEPHONE:
(707) 447-7685
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:75CENSUS: 29DATE:
12/13/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Brenda Hardaway - Center DirectorTIME COMPLETED:
06:00 PM
NARRATIVE
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During the course of a complaint investigation visit, Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced Case Management visit and met with Center Director (CD), Brenda Hardaway, to deliver several deficiencies as a result of a substantiated complaint investigation which alleged unqualified staff were attending to daycare children. LPA interviewed four staff (S1-S4) and four adults (A1-A4), starting on 10/03/23 through 10/04/23. Statements provided by S1-S4 and A1-A4 validated they were either an unqualified staff that was left alone to work with the children or they were aware of, and during their visit(s) to the facility; they witnessed unqualified staff working alone in a preschool class. Several staff reported that on multiple occasions during the summer of 2023, CD instructed some unqualified staff to work alone with up to 16 children and they worked at the capacity of fully qualified teacher. Staff and adults alleged that CD did not provide adequate staffing to support the classroom, and the substantiated finding had a impact on the ratio requirements. The facility did not comply with ratio requirements of California Code of Regulations 101216.3(a), which indicates there shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance.

Furthermore, LPA conducted an interview with CD to investigate an incident surrounding the circumstances involving a child (C1) walking out of the facility. The facility self reported the incident on 10/27/23. LPA conducted an interview with CD who confirmed that on 10/25/23 at between 10:40am through 10:45am, a child (C1) walked out of the facility's exterior wooden side gates because the gates were propped opened by a food service vendor. CD explained that at the time, there were two staff on the playground supervising about 10 children, the staff were not paying attention and did not notice C1 had left the playground until CD noticed C1 standing outside the facility entry door for about one minute. CD's statement confirmed there was a lack of supervision which resulted in C1's eloping from the facility. CD said she would take positive steps by conducting frequent and periodic checks in each classroom and on the playgrounds, and conduct a head counts of children to ensure the census matched the facility’s Child Supervision Record (CSR); and also, she would ensure staff were interacting and remained engaged with the children in care. (Continue to LIC 809-C)
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 483001828
VISIT DATE: 12/13/2023
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Exit interview conducted and report was reviewed with the Facility Representative, Brenda Hardaway. 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. California Code of Regulations, Title 22, Division 12, are being cited on the attached LIC 809-D. Appeal Rights were provided.

LPA Melchisedeck Augustin informed Facility Representative, Brenda Hardaway that this report dated 12/13/2023 documents two Type A citations which shall be posted for 30 consecutive days as there is/are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Melchisedeck Augustin informed the Facility representative to provide a copy of this licensing report dated 12/13/23 that documents any Type A citation(s) 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.

SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/13/2023 05:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 483001828

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/14/2023
Section Cited
CCR
101216.3(a)

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There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This requirement was not met as evidenced by: Based on a substantiated complaint allegation which corroborated a the facility operated out of ratio on multiple occasions.
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Director stated she would produce a written statement outlining how she would ensure each classroom was in ratio at all times. Center Director stated she would submit the POC by 12/14/23 via mail, email or fax.
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This poses/posed an immediate health, safety and/or personal rights risk to the children in care.
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Email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099
Type A
12/14/2023
Section Cited
CCR101229(a)(1)

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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.

This requirement was not met as evidenced by: Based on the Director's statement confirmed there was a lack of supervision which resulted in a child (C1) eloping from the facility.
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Director stated she would produce a written statement outlining how she would ensure supervision of the children at all times. Center Director stated she would submit the POC by 12/14/23 via mail, email or fax.
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This poses/posed an immediate health, safety and/or personal rights risk to the children in care.
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Email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099
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: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2023
LIC809 (FAS) - (06/04)
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