483001834-1-3-2023-01-CC-LLEI-CMT45T-20230105174830

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483001834
Report Date: 01/03/2023
Date Signed: 01/03/2023 05:23:47 PM

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
09/19/2022 and conducted by Evaluator Elpidia Hernandez Torres

COMPLAINT CONTROL NUMBER: 01-CC-20220919180402

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	483001834
ADMINISTRATOR:	WENDY CERTEZA		FACILITY TYPE:	830
ADDRESS:	1611 WOOD CREEK DRIVE		TELEPHONE:	(707) 426-2275
CITY:	FAIRFIELD	STATE: CA	ZIP CODE:	94533
CAPACITY:	36	CENSUS: 21	DATE:	01/03/2023
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Facility Representative Arianna Kalista		TIME COMPLETED:	05:05 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained unexplained injury while in care
Neglect after child sustained unexplained injury while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

An unannounced visit was made today by Licensing Program Analysts (LPAs), Elpidia Hernandez Torres and Melchisedeck Augustin to deliver the complaint investigation findings regarding the above allegations. The LPAs met with the facility’s representative Arianna Kalista. This complaint was investigated by the Department’s Investigative Branch (IB) Investigator, Sergio Guerra, who initiated the investigation on 09/22/2022 by conducting interviews and reviewing records. It was alleged that a child (C1) sustained an unexplained injury while in care and child neglect after child sustained the unexplained injury while in care, specifically that facility staff neglected to act promptly to seek timely medical attention for C1 following the observation of a lump on C1’s left side of the head on 09/16/2022.

On 09/22/2022, 11/10/2022, 11/18/2022, and 11/29/2022, Investigator Guerra conducted interviews with staff, guardians, medical professionals, and children services staff. Also, during the course of the investigation, medical records and reports from law enforcement and children services agencies were reviewed. Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres	TELEPHONE: (707) 771-5568
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2023

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 2

Control Number 01-CC-20220919180402

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: 483001834
	VISIT DATE: 01/03/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Facility staff denied the allegations claiming that as soon as the lump was observed while changing C1’s diapers on 09/16/2022, the guardian was called to pick up and take C1 to the doctor for medical treatment. Evidence did reveal a visible lump as early as 09/14/2022, however staff stated that they were not informed or aware of any injury prior to 09/16/2022 and believed that the injury did not take place at the facility as they would’ve known if the injury occurred while C1 was at the facility.

The guardians did observe a lump/bump on 09/13/2022 but after assessing and observing that C1 was acting fine with no change in behavior, it was determined that no further follow up was necessary at that time. The guardians did not notify the facility staff and did not know when or where the injury occurred.

Medical records indicate that the injury was “non-specific”, the cause is unknown, and it could not be determined if it was due to an accident or abuse. The medical professional further stated that if C1 was “fine” following the injury, it’s reasonable to not seek medical attention sooner. It could not be medically concluded where, when, or how C1 was injured.

Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. Therefore, the findings are unsubstantiated. There were no Title 22 deficiencies cited today. Appeal Rights were provided. The Notice of Site Visit shall be posted for 30 days.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres	TELEPHONE: (707) 771-5568
LICENSING EVALUATOR SIGNATURE:	DATE: 01/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2