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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270381
Report Date: 06/16/2022
Date Signed: 06/16/2022 11:12:36 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/27/2022 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220427113142
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270381
ADMINISTRATOR:NEHEZ, REBECCAFACILITY TYPE:
840
ADDRESS:25507 MOULTON PARKWAYTELEPHONE:
(949) 470-0099
CITY:ALISO VIEJOSTATE: CAZIP CODE:
92656
CAPACITY:38CENSUS: 8DATE:
06/16/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ella Lopez, Head TeacherTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Facility has an outbreak.
Facility failed to meet reporting requirements.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 6/16/22. LPA met with Head Teacher Ella Lopez, and at 930am LPA conducted a tour of the facility and census of children was taken. LPA observed 8 school age children with 1 teacher. On 4/27/22 a complaint was filed with the Department alleging the above. During the course of the investigation, LPA interviewed five staff, five school age children, conducted 2 separate physical plant inspections of each preschool classroom on 4/29/22 and 6/16/22, and gathered and reviewed facility documentation related to the allegation; including an unusual incideint report. From information obtained from interviews with the director, staff, and children it has been determined that there is a preponderance of evidence to support the allegations that the facility had an outbreak and failed to report the outbreak to Licensing. LPA interviewed five staff on 4/29/22, and determined from these interviews that 8 individuals, including 1 staff were infected with Hand Foot Mouth disease, a minor contagious illness affecting the digestive system. Facility must assess all children entering the facility for illness, to prevent spread of contagious illnesses, including Hand Foot Mouth disease. (continued on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/27/2022 and conducted by Evaluator Dean Valencia
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20220427113142

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270381
ADMINISTRATOR:NEHEZ, REBECCAFACILITY TYPE:
840
ADDRESS:25507 MOULTON PARKWAYTELEPHONE:
(949) 470-0099
CITY:ALISO VIEJOSTATE: CAZIP CODE:
92656
CAPACITY:38CENSUS: 8DATE:
06/16/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ella Lopez, Head TeacherTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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9
Facility is unsanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Dean Valencia conducted an unannounced complaint inspection on today's date, 6/16/22. LPA met with Head Teacher Ella Lopez, and at 930am LPA conducted a tour of the facility and census of children was taken. LPA observed 8 school age children with 1 teacher. On 4/27/22 a complaint was filed with the Department alleging the above. During the course of the investigation, LPA interviewed five staff, five school age children, conducted 2 separate physical plant inspections of each preschool classroom on 4/29/22 and 6/16/22, and gathered and reviewed facility documentation related to the allegation; including an unusual incideint report. During LPA's observations of the classrooms, LPA observed facility staff maintain a sanitary classroom, and remaining in compliance of Title 22 Regulations pertaining to Buildings and Grounds. Staff were interviewed by LPA on 4/29/22 and during the interviews staff exhibited knowledge of Building ansd Grounds regulations and stated they are always to be within complaince of the discussed Title 22 Regulations. Children were interviewed on 6/16; and stated that the facility is sanitary and staff regulalry maintain a safe and clean environment,
(continued on LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20220427113142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270381
VISIT DATE: 06/16/2022
NARRATIVE
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(page 2)
Based on this gathered information the allegation of facility is unsanitary was not determined to have a preponderance of evidence. In addition to this, LPA was unable to demonstrate that this allegation or that the facility at no point in the past was unsanitary, was ever untrue. LPA was unable to make the determination from the information gathered that this allegation did not ever occur, or that there wasn't a preponderance of evidence to support this allegation, at some point. Due to this reasoning the most factual finding on the allegation, with all available information to LPA during the investigation is unsubstantiated.

Based on all this information LPA gathered, the preponderance of evidence standard for the allegation was not met, therefore the above allegation is found to be unsubstantiated. From all of the available information obtained by LPA during the course of the investigation, that there is insufficient evidence indicating that the facility is unsanitary. Based on all of the information LPA gathered, LPA was not able to determine that this allegation was false or untrue. Therefore LPA cannot make the determination that this allegation is unfounded; and the most accurate findings would remain at unsubstantiated.

Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is unsubstantiated. Exit interview was conducted, and report was reviewed and discussed. Notice of Site Visit was posted during the visit. The facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100 per day. The facility was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20220427113142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270381
VISIT DATE: 06/16/2022
NARRATIVE
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(page 2)

Once this illness affected more than 1 household of people present at the facility this must be reported to Licensing within 24 hours; and determined through interview the illness was not reported. From this information LPA determined that there was a preponderance of evidence to further support the allegations that the facility had an outbreak and the facility failed to report the outbreak.

Based on the information gathered over the course of the investigation by LPA, it was determined that the preponderance of evidence standard was met and the allegations are substantiated. The substantiated allegations constitute a violation of Daily Assessment for Illness and Reporting Requirements; Title 22 Regulation sections 101226.1(a) and 101212(d)(1)(E), respectively. Two separate B violations are cited and can be reviewed on the attached LIC9099D page.

Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the facility representative, who was a head teacher due to the absence of both Director and Assistant Director during the time of the inspection on today's date 6/16/22.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 06-CC-20220427113142
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270381
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/23/2022
Section Cited
CCR
101212(d)(1)(E)
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Reporting Requirements: Events reported shall include the following: (E) Epidemic outbreaks. This was not as evidenced by:

Based on interviews conducted by LPA, it was determined that the facility had a contagious outbreak of Hand Foot Mouth disease that affected 8 individuals from
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The director submitted an Unusual Incideint Report LIC624 form to CCL office soon after the initial complaint inspection on 4/29/22. The director was provided with a copy of the Title 22 Regulations Reporting Requirements section, and reviewed reporting requirements with director.
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multiple households. The facility did not report this outbreak to CCL office. This constitutes a potential threat to the children's health and safety.
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Type B
06/23/2022
Section Cited
CCR
101226.1(a)(1)(B)
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The licensee shall be responsible for ensuring that children with obvious symptoms of illness including, but not limited to, fever or vomiting, are not accepted.(1)Additional attention shall be paid to children who:(B)Have been exposed to a contagious disease.This was not met as evidenced by:
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The director submitted an Unusual Incideint Report LIC624 form to CCL office soon after the initial complaint inspection on 4/29/22. The director was provided with a copy of the Title 22 Regulations Daily Inspection for Illness section, and reviewed daily illnes assessment requirements of all staff, with director. Director will submit to LPA via
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Based on LPA's interviews it was determined that the facility allowed for Hand Foot Mouth disease to spread to 8 individuals in the facility. Based on the extent of the outbreak, the facility was not sufficiently assessing individuals for illness, including those that were exposed to HFM disease. This constitutes a potential threat to the health and safety of children.
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email a detailed plan for how staff will ensure they are conducting daily inspection for illness. Verfiifcation will be included that all staff acknowledge this information. This email will be sent to LPA by 6/23/22.
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: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Dean ValenciaTELEPHONE: (714) 215-6737
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5