304270397-9-19-2023-06-CC-NKTN-CVTQK8-20230919121354

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304270397
Report Date: 09/19/2023
Date Signed: 09/19/2023 12:14:02 PM

Document Has Been Signed on 09/19/2023 12:14 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	304270397
ADMINISTRATOR:	JASMIN CANALES		FACILITY TYPE:	850
ADDRESS:	4601 BEACH BLVD.		TELEPHONE:	(714) 994-5610
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90621
CAPACITY: 92	TOTAL ENROLLED CHILDREN: 92	CENSUS: 6	DATE:	09/19/2023
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Jasmin Canales, Director		TIME COMPLETED:	12:30 PM

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	Licensing Program Analysts (LPA) Tran conducted a case management inspection to follow up on a self-report unusual incident that was submitted to CCL Regional Licensing Office on 09/18/2023. It was reported by Director Jasmin Canales, on Fri 09/15/23, about 9am, Child #1 (C1) and Child #2 (C2)'s parents met with Director, and informed Director that C1 told the C1's parent that C1 saw Staff #1 (S1) pulled C2's hair in class. Director acknowledged the concern and informed parents that Director will conduct an internal investigation to address the concern, and will follow up with the parents with updates. After the the parents left, Director went to the classroom to meet with C1, as the Director entered the classroom, staff #2 informed Director that C1 had just told the whole class about witnessing S1 pulling C2's hair. Director met with C1 and C1 disclosed, "Yes, I saw S1 pulled C2's hair because C2 was throwing paper towel into the toilet instead of the trash can" Director then met with C2 separately and C2 confirmed that S1 did pull C2's hair because C2 was in trouble yesterday. Director was asking follow up questions as to when and where and why S1 pulled C2's hair but C2 did not provide any further details. Later that day, C2's parent called and was questioning Director if Director was going to do something to address the concern, once again Director reassured the parent of C2 that an internal investigation was being conducted and that Director will keep the parents updated. During facility's internal investigation, Director met with other children and asked them if they have witnessed anything. The children provided inconsistent details. Director asked S1 questions about the incident, S1 reported that S1 did not recall the incident. S1 said that S1 usually fixes the children's hair after nap time, and that C2 was not in class on 09/14/23. Director verified schedule and C2 was attending in another classroom that day, however C2 did get transferred into S1's classroom at approximately 12:20pm and stayed in S1's classroom till pick up time at 5pm. S1 was the only teacher in the classroom from 7:30am to 4:30pm with a lunch between 12:23pm-1:24pm that day. Director provided updates to the involved parents. On 09/18/23, at about 10am, C6's parent met with Director and informed Director that on the evening of 09/15/23, C6 told the parent that S1 had pulled C6's ear in class. Director met C6 and was not able to obtain any information from C6 regarding the alleged incident. (Continue next page)

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

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

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 304270397
	VISIT DATE: 09/19/2023

NARRATIVE

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During today's inspection a tour of the facility was conducted. There were 6 children in Pre-K classroom; with one staff supervising. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. During today's inspection staff members and children were interviewed. LPA also obtained facility roster and attendance sheet.

Due to insufficient information available at this time and further interviews needed, the above incident needs further investigation.

Exit interview was conducted. The Notice of Site Visit was posted. Director was advised the Notice of Site Visit must be posted for 30 days or 100$ Civil Penalty will be assessed.

(End of Report)

SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

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