483001837-1-13-2021-01-CC-LLEI-BXHSUU-20210122131144

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483001837
Report Date: 01/13/2021
Date Signed: 01/13/2021 04:21:13 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/29/2020 and conducted by Evaluator Melchisedeck Augustin

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20200529122330

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	483001837
ADMINISTRATOR:	SHANNON BARTLETT		FACILITY TYPE:	830
ADDRESS:	35 ROTARY WAY		TELEPHONE:	(707) 557-3007
CITY:	VALLEJO	STATE: CA	ZIP CODE:	94591
CAPACITY:	36	CENSUS: 7	DATE:	01/13/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Rose Canarios-Center Director		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Daycare child sustained unexplained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Melchisedeck Augustin conducted a subsequent video conference Tele-Investigation with the Center Director Rose Canarios (CD) to deliver the finding regarding the allegation mentioned above. Due to COVID-19, the Department has suspended field operations, and CD agreed to meet with LPA via video conference. LPA previously met with Assistant Director Tiffany Fox (AD) on 06/03/20 and 06/22/20 to discuss the purpose of the inspections and obtained a facility roster. It was alleged that a daycare child (C1) sustained unexplained injuries while in care. The statement noted there were strap marks below C1’s chest and several pinkish colored scratches on the left side of the neck.

On 06/03/20 starting at 10:01am, LPA interviewed AD and staff (S1). On 06/12/20, the facility submitted an unusual incident report (UIR), surrounding the incident. On 06/22/20, LPA conducted follow up interviews with AD and S1, and made observations in the classroom. On 12/14/20, LPA conducted subsequent interviews with parents. According to the AD’s statement, AD conducted a wellness check on C1’s arms, stomach and legs, and did not see any visible scratches or bruise(s) on C1’s neck or chest area. (Continue to LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck Augustin	TELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20200529122330

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 483001837
	VISIT DATE: 01/13/2021

NARRATIVE

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AD claimed that the toddler classroom does not have highchairs, and the available highchairs in the Infant classroom had adjustable straps to safely secure a child. AD further claimed that C1 did not get injured as a result of a lack of supervision. S1 stated that she secured C1 in a highchair that was low to the ground, that the highchair has seat belts with three points straps that go in between a child’s legs and hip; and there was enough room for staff to put her hand through so the seat belt was not tight. S1 claimed to know how to properly fasten highchair seats and that C1 was always secured when in the chair. Also, there were no reports of any prior incidents where C1 fell off or bumped C1’s head on the chair.

Statement accounts provided by parents (P2 and P3) did not indicate that parents witnessed any incident(s) that resulted in C1 sustaining unexplained injuries and parents did not report that their child had sustained injuries which caused concern. Although P3 reportedly saw a visible, pinkish colored, rock size bump on P3 child’s head, staff had provided P3 with a written document and an explanation of how the injury occurred. Parents statements did not provide evidence to support the allegation that C1 sustained unexplained injuries while in care. During LPA’s inspection of the Infant and toddler classroom, respectively on 06/22/20 at 12:07pm and 12:09pm, LPA observed S1 supervising three children napping on cots and one staff supervising two children napping in cribs, and LPA did not observe any hazards or unusual incidents that resulted in any child(ren) getting injured.

Based on the LPA’s investigation, there is not enough evidence to support the allegation that C1 sustained unexplained injuries while in care, and therefore the above allegation is found to be unsubstantiated. CD’s signature was not recorded on this Complaint Investigation Report (CIR), however; CD was provided with a copy of this CIR, and CD’s confirmation of read receipt is on file. LPA conducted an exit interview with CD. There were no Title 22 deficiencies cited during today’s inspection. Appeal Rights were provided.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck Augustin	TELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

LIC9099 (FAS) - (06/04)

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