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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483001833
Report Date: 09/04/2024
Date Signed: 09/04/2024 04:20:29 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 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
08/27/2024 and conducted by Evaluator Robert Maciel
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240827084414
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001833
ADMINISTRATOR:WENDY CERTEZAFACILITY TYPE:
840
ADDRESS:1611 WOOD CREEK DRIVETELEPHONE:
(707) 426-2275
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:50CENSUS: 12DATE:
09/04/2024
UNANNOUNCEDTIME BEGAN:
01:42 PM
MET WITH:Wendy CertezaTIME COMPLETED:
04:33 PM
ALLEGATION(S):
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Staff did not prevent child from harming another child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Selena Mariani and Robert Maciel, conducted a subsequent complaint investigation inspection for the purpose of delivering the findings regarding the above allegation. It was alleged that staff did not prevent child from harming another child in care, specifically that staff were unaware that a child kicked another child.

During the course of the investigation, interviews were conducted with two staff and two adults from 8/30/24 - 9/4/24. During today's inspection, LPAs toured the faciltiy and requested facility documents. Staff interviews, facility documentation, and an unusual incident report that was submitted to the department on 9/3/24 corroborate the allegation that facility staff were unaware that child 1 (C1) was kicked by child 2 (C2) when the incident occured.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
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 3
Control Number 01-CC-20240827084414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001833
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/20/2024
Section Cited
CCR
101229(a)
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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as neccesary to meet the children's needs. This was not met as evidenced by...
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LPAs gave Director the following forms: National Center Early Childhood Health and Wellness: Active Supervision, Teaching Pyramid: But WHat Do I Do When He Hits, Active Supervision Tool Kit, and Active Supervision at a Glance.
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Based on interviews conducted and records reviewed, staff did not observe child 1 (C1) being kicked in an incident which occured on 8/23/24 which poses a potential health and safety risk to children in care.
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Director stated she will review the forms during a staff meeting on 9/19/24 and email LPA Selena Mariani at selena.mariani@dss.ca.gov, proof of staff attendance.
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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: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20240827084414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001833
VISIT DATE: 09/04/2024
NARRATIVE
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Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. The facility was previously cited for the same deficiency on 10/19/23. Civil penalties are assessed on form LIC421FC for the repeat violation within 12 months, in the amount of $250. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3