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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270924
Report Date: 06/13/2023
Date Signed: 06/13/2023 05:01:52 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, 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
06/07/2023 and conducted by Evaluator Pat Rivas
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20230607122933
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270924
ADMINISTRATOR:STRAND, STEPHANIEFACILITY TYPE:
830
ADDRESS:855 PASEO WESTPARKTELEPHONE:
(949) 262-0260
CITY:IRVINESTATE: CAZIP CODE:
92604
CAPACITY:48CENSUS: 30DATE:
06/13/2023
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Stephanie Strand, DirectorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Neglect/Lack of Care and Supervision-Staff left an infant alone in the infant room
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) P Rivas conducted an unannounced complaint visit to investigate the above allegation. LPA was met by director, Stephanie Strand who was explained the reason for today’s visit. Cenus was taken; Room(RM)1 had 4 infants and 1 teacher; Rm2 had 7 infants and two teachers, Rm3 had 12 infants and 3 teachers, Rm4(toddler 2) had 8 infants with two teachers on outside yard.

A review of the Facility Personnel Report on Guardian on today's date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
On 06/07/2023, the regional office received a complaint alleging, staff left an infant alone in the infant room. It was alleged that on 06/06/23 at approximately 4:00pm staff1(S1) left Child1(C1) in infant room 2.

cont. 9099c
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
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 5
Control Number 06-CC-20230607122933
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: 304270924
VISIT DATE: 06/13/2023
NARRATIVE
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page 2
The investigation consisted of staff interviews and review of C1's file. The following was found;
S1 had three children under his/her care at the time. S1 had moved two of them from RM1 to RM2. There is a door in the middle of the classroom that connects the rooms. S1 was transferring children then realized s/he left C1 in the crib in RM1, sleeping for about 4-5 minutes when s/he realized s/he left C1 sleeping and went back. Interview with S1 indicated as s/he walked back into RM1, C1 was waking up. S1 had stated that s/he, usually does not begin to transfer children until all of them are awake but stated did not have an excuse as to why s/he left C1 alone in crib . S1 admitted to leaving C1 unattended in the crib which was located in RM1 in the sleeping area . LPA observed the crib is located in the NW corner of the room and there is a wall between RM1 and Rm2, There was no line of sight from RM2 to RM1. From location of S4 and S1, C1 was 25 to 30 feet away from staff. Interview with 3 out of 4 staff indicated the door between the rooms was closed. LPA observed door close through it's own volition. Interview with 3 out of 4 staff indicated C1 was left alone 4-5 minutes. Per interviews, S1 and S4 were near the changing tables , S2 and S3 were by the sink in RM2. S3 was picking up their own child. Interview with Director found she reported incident to Community Care Licensing (CCL) on 06/09/23 which is when staff reported incident to Director.

Review of records show that C1 was napping from 4:07pm to 4:39pm. There were no documented 15 minute check based on review. The Child Supervision Report(CSR) (Name to Face) from RM2 indicated C1 was not received until 4:44pm. The CSR from RM2 it is noted child was transferred at 4:39pm. Interviews with staff indicated on the IPAD the staff have the option of ending nap time , "now", "5 minutes ago", "10 minutes ago". Documents show that C1's nap time ended at 4:39 which is not consistent with statement provided by S1 who admitted to transferring C1 after C2 and C3 but all transfer times stated 4:39pm.

Based on LPA staff interviews and statements, it was revealed that child (C1) was left alone in crib in Room1 on 06/06/23 for approximately 4-5minutes without any staff supervision. (C1) was left unattended while staff was in another room (Room2) without line of sight. The following violations are being cited in accordance with California Code of Regulations, Title 22, Division 12, Chapter 1, 101229 (a)(1); 101429(a)2(B) and . Please see the attached LIC 9099D.



cont. page 3
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 06-CC-20230607122933
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: 304270924
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/14/2023
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time.... Supervision shall include visual observation.
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Director agreed to conduct a training for the staff in relation to Responsibility for Providing Care and Supervision, provide training for closing class room and transition procedures. Director also agreed to show CCL Dpt videos as part of training. Copy of training
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Based on staff interviews and statements, it was revealed that Child (C1) was left unattended in crib, in room 1 while staff was in room2. This poses an immediatel health and safety and personal rights risk to children in care
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 and sign in sheet for infant teachers to be provided by plan of correction date to LPA

https://ccld.childcarevideos.org/child-care-center-operators/
Deficiency Dismissed
Type B
06/23/2023
Section Cited
CCR
101212(d)1(C)
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Reporting Requirements, Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Dept by telephone or fax within the Depts next working day... Any unusual incident or child absence that threatens
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Director stated she reported the incident as soon as she was made aware of the incident. Will also train all staff on reporting requirements. Director to provide LPA with sign in sheet and training information by plan of corretion date.
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 the physical or emotional health or safety of any child. This was not met as evidenced by review of records incident that occurred on 06/06/23 was not reported to CCL until 06/09/23. This poses a potential health, safety and personal rights risk to 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.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 06-CC-20230607122933
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: 304270924
VISIT DATE: 06/13/2023
NARRATIVE
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page 3

LPA Rivas informed Director Stephanie Strand that this report dated 06/13/2023 document(s) one Type A and two Type B citation(s) 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 Rivas informed Director Stephanie Strand to provide a copy of this licensing report dated 06/13/2023 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.

Exit interview conducted and report was reviewed with Director Stephanie Strand. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



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

end of report

SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 06-CC-20230607122933
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: 304270924
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/23/2023
Section Cited
CCR
101429(a)(2)B
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Responsibility for Providing Care and Supervision for Infants,Sleeping infant(s) shall be directly observed by sight and sound at all times,Staff shall physically check on sleeping infant(s) every 15 minutes and document the following:
1. Labored breathing.2. Signs of distress...
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Director will retrian staff how to do the app but is going to go back to paper form in order for Director to check daily, during naps. Director will provide copy of actual random sample nap logs for one working week for 10 children in care.
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 This requirement was not met as evidenced by review of records. In 1 out of 1 records reviewed there were no sleep checks documented from 060623 to 060823. This poses a potential health and safety and personal rights risk to 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.
SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Pat Rivas
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5