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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483001833
Report Date: 10/19/2023
Date Signed: 10/19/2023 10:48:00 AM

Substantiated


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
07/21/2023 and conducted by Evaluator Elpidia Hernandez Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230721100838
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001833
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
840
ADDRESS:1611 WOOD CREEK DRIVETELEPHONE:
(707) 426-2275
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:50CENSUS: 0DATE:
10/19/2023
UNANNOUNCEDTIME BEGAN:
08:26 AM
MET WITH:Assistant Center Director ShirinTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff did not properly supervise child, resulting in a child choking another child
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Elpidia Hernandez Torres and Cindy Castro, conducted a subsequent complaint investigation inspection on 10/19/23 at 08:30AM for the purpose of delivering the findings regarding the above allegation. LPA Hernandez Torres previously met with Assistant center director Shirin on 07/27/23 to discuss the purpose of the visit, request children roster, CSRs from 07/14-07/21 and incident reports from 06/26-07/26 . It was alleged that staff did not properly supervise child, resulting in a child choking another child.

During the course of the investigation, interviews were conducted with the center director, assistant center director, two staff, four children (C1-C4) and three guardians ( G1-G3) between 07/27-10/13. continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
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
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
07/21/2023 and conducted by Evaluator Elpidia Hernandez Torres
COMPLAINT CONTROL NUMBER: 01-CC-20230721100838

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001833
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
840
ADDRESS:1611 WOOD CREEK DRIVETELEPHONE:
(707) 426-2275
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:32CENSUS: 0DATE:
10/19/2023
UNANNOUNCEDTIME BEGAN:
08:26 AM
MET WITH:Assistant Center Director ShirinTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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9
Staff commingle children
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Elpidia Hernandez Torres and Cindy Castro conducted a subsequent complaint investigation visit with assistant center director for the purpose of delivering complaint investigation findings. It has been alleged Staff commingle children.

During the initial investigation an interview was conducted with the center director, assistant center director, two staff, four children (C1-C4) and three guardians ( G1-G3) between 07/27-10/13. Center Director reported center does not co-mingle children between the licenses, and children transition from the preschool license to the school age license during the summer if they are 5 years old.
continued on 9099-c
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20230721100838
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: 483001833
VISIT DATE: 10/19/2023
NARRATIVE
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Assistant center director corroborated the statement, reporting once children begin kindergarten the center tells parents to move the child up to the next license, but if guardians want to keep their child in the preschool license they can as the preschool license states 2 years old to entry into first grade. C3 reported sometimes she goes into the TK classroom under the preschool license and the last time she was in the TK class was 09/19/23.

Some guardians reported their children have moved up pretty quickly through the classes and were told when their child has moved up to the next class. One guardian (G2) reported their child had been moved from the school age class to a class under the preschool license at least two times but couldn’t recall which classroom it was. The same guardian also reported on three or four occasions her daughter enrolled in the school age license was asked if she wanted to read and play with the toddlers and she did. LPA was not able to interview G2’s children.

Based on interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is Unsubstantiated. This report was reviewed and discussed with assistant center director, She was provided with a copy of this CIR; and Appeal Rights. All licensing reports are public information and must be made available upon request for at least three years.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 01-CC-20230721100838
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: 483001833
VISIT DATE: 10/19/2023
NARRATIVE
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Center Director reported there was an incident where two children (C5, C6) were playing and a third child (C7) was bothering them, so one child (C5) put her hands on C7’s neck, grabbing C7’s neck. Staff interviewed reported they didn’t see the incident but had heard about it from other staff. C1 reported another child C8 pulled his (C1)’s hoodie from the back choking him and the teacher didn’t see it happen. G1 reported C8 had put his hands around C1’s neck on one occasion, and pull C1’s hoodie choking him on another occasion. G2 reported a staff member told her, her child (C9) had put his hands on another child around the neck, and on a different day had returned home with his shirt pulled from the neck. G3 reported her child had told her C5 choked C7. All three guardians reported the choking could have been prevented if staff were supervising.

Based on interviews conducted, the preponderance of evidence standard has been met and the above allegation is found to be substantiated. The California Code of Regulations, Title 22, Division 12 & Chapter 1, section 101229(a) is being cited on attached LIC 9099D . This report was reviewed with the assistant center director and an exit interview was conducted. This Complaint Investigation Report (CIR), was provided Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20230721100838
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: 483001833
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/02/2023
Section Cited
CCR
101229(a)
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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. This was not met as evidence by. . .
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Assistant center director reported since the incident had occured, the center had conducted one on one training with the staff. Center agreed to take training on active supervision.
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Based on interviews conducted, staff were present in the classroom and did not witness the choking. Also Staff did not prevent the situation from escalating. This poses a potential health and safty risk to children in care.
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And email, mail or Fax LPA Hernandez Torres, attendance sheet of the staff who participated in the active supervision training.
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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.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5