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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493003399
Report Date: 11/01/2023
Date Signed: 11/01/2023 04:55:46 PM


Document Has Been Signed on 11/01/2023 04:55 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:
493003399
ADMINISTRATOR:MINDY MERONEKFACILITY TYPE:
850
ADDRESS:1485 N. MC DOWELL BOULEVARDTELEPHONE:
(707) 794-0211
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY:85CENSUS: 57DATE:
11/01/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Brenda BustamanteTIME COMPLETED:
04:41 PM
NARRATIVE
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An unannounced case management inspection visit to the facility was made today by Licensing Program Analyst (LPA) Y. Yang in response to a written unusual incident report (UIR) received by the Department on 09/29/23. During today’s inspection visit, the LPA met with the interim center director, Brenda Bustamante to discuss the incident. It was reported by former center director, Mindy Meronek that on 09/26/23, staff S1 observed and video recorded staff S2 using “inappropriate child guidance” while putting child C1 to nap. Meronek reported that upon learning of this, staff S2 was placed on administrative leave while the center performed its investigation. Meronek reported that while the video did not show anything “abusive or aggressive in nature” it did violate KinderCare’s “child guidance policies.” Meronek reported that once the investigation was concluded, staff S2 resigned from their position at the center. Based on the LPA’s interviews with staff on 11/01/23, it was corroborated that S2 pushed the back of C1’s head towards their cot as C1 attempted to sit up while on their knees on their cot. Based on interviews, it was reported that C1 did not appear to be distressed or upset.

Meronek reported that the authorized representative(s) of child C1 were notified, and an in-person meeting was held to discuss the incident. This self-reported incident was reported to Community Care Licensing as required. Based on available information, California Code of Regulations, Title 22 is being cited on the attached LIC 809-D. An exit interview was conducted, and this report was read and discussed with the facility’s interim center director, Brenda Bustamante. Appeal rights were provided. The Notice of Site Visit shall be posted for 30 days.

SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 11/01/2023 04:55 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: 493003399

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/30/2023
Section Cited
CCR
101223(a)(3)

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Personal Rights (a)The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.

This requirement was not met as evidenced by:
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Interim Director Brenda Bustmante stated that staff S2 is no longer employeed by the center. Bustamante stated that during the center's next all staff meeting on 11/30/23, staff will watch the Children's Personal Rights in Care video on the CCLD website https://ccld.childcarevideos.org/child-care-center-operators/childrens-personal-rights-in-child-care/ and review the written regulation during their all staff meeting. A sign in sheet with staff names and signatures to verify training will be submitted to the LPA via email by COB 11/30/23.
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Based on interviews conducted and documents obtained, it was corroborated that staff S2 roughly handled child C1 as C1 attempted to sit up in their cot during nap time. This posed a health, safety and personal rights risk to the children in care.
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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.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang YangTELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2