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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013412608
Report Date: 04/05/2023
Date Signed: 04/05/2023 03:25:16 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/22/2023 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20230322164928
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
013412608
ADMINISTRATOR:JAMIE CZELUSNIAKFACILITY TYPE:
850
ADDRESS:4655 LASSEN ROADTELEPHONE:
(925) 455-1560
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:72CENSUS: 32DATE:
04/05/2023
UNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Jaime CzelusniakTIME COMPLETED:
03:23 PM
ALLEGATION(S):
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Personal Rights - Staff grabbed daycare child causing an injury
INVESTIGATION FINDINGS:
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On 4/5/2023 at 1:27pm Licensing Program Analyst (LPA) Morgan Pringle met with Director Jaime Czelusniak for a complaint that was filed against the facility alleging a child's personal rights were violated. Facility is dual licensed and holds a license for infants (013412610) and school age (013412609). Present during the visit was thirty-two (32) preschool children and five (5) teachers.
Throught interviews and record reviews it was found that a preschool age child did not want to go outside during a classroom transition. A teacher tried to get the child to go outside using multiple techniques, but the child refused. The teacher then grabbed the child by the arms and pulled the child outside resulting in an injury. The teacher was suspended the day of the incident and was untimately terminated.
LPA determined 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. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
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 3
Control Number 52-CC-20230322164928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 013412608
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/12/2023
Section Cited
CCR
101223(a)(3)
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101223(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...
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Each staff member (all teachers and Directors) will watch the video titled "Children's Personal Rights in Child Care" on the CCLD website. Staff will submit to the Director a statement on how they will ensure each child's personal rights are met. Director will submit all statements to LPA Pringle by POC date.
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This requirement was not met as evidenced by: A teacher grabbed a child by the arms and pulled them out of the classroom resulting in an injury. This poses an immediate risk to the health and safety of 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: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 52-CC-20230322164928
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 013412608
VISIT DATE: 04/05/2023
NARRATIVE
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LPA Pringle informed Director that this report dated 4/05/2023 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Pringle informed the Director to provide a copy of this licensing report dated 4/05/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given to licensee and must be posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Director Jaime Czelusniak.

SUPERVISOR'S NAME: Jason JangTELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan PringleTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3