334804325-4-12-2024-10-CC-CMAZ-D58P58-20240513110016

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 334804325
Report Date: 04/12/2024
Date Signed: 04/12/2024 11:12:48 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/27/2024 and conducted by Evaluator Kelli Waters

PUBLIC

COMPLAINT CONTROL NUMBER: 10-CC-20240327093704

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	334804325
ADMINISTRATOR:	MARGARITA D. GUILLERMO		FACILITY TYPE:	830
ADDRESS:	23301 OLIVEWOOD PLAZA DRIVE		TELEPHONE:	(951) 924-1956
CITY:	MORENO VALLEY	STATE: CA	ZIP CODE:	92553
CAPACITY:	40	CENSUS: 28	DATE:	04/12/2024
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Farhana Alam		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Infant sustained injury while in care due to lack of supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelli Waters and Licensing Program Manager (LPM) Carlos Martinez arrived unannounced to the day care center to investigate the above stated allegations. LPA advised Assistant Director Farhana Alam of an open investigation. LPA conducted a tour and census of the facility. LPA conducted interviews with six staff including the director, made observations, and reviewed and received documentation.

It was alleged a child in care sustained an injury due to lack of supervision. 6 out of 6 staff interviewed and a review of facility documentation did not provide evidence of lack of supervision leading to the child’s injury.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

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

LIC9099 (FAS) - (06/04)

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Control Number 10-CC-20240327093704

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 334804325
	VISIT DATE: 04/12/2024

NARRATIVE

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During the time of the injury, 3 qualified staff members were present with 11 children in care and the day-care was in ratio. Per interviews conducted, the incident occurred during meal time and at the time the child was sitting on a chair then stood up on it facing the rear and suddenly slipped and hit his chin which resulted in the injury. LPA confirmed that first aid was immediately applied to child and subsequent injury reports and parent notification took place. Due to child bleeding slightly from the mouth, staff placed the child on a changing table to inspect the injury further but did not observe the cut and the child did not complain of any pain. LPA confirmed that the child eventually ate lunch and then took a nap, but did not express any pain for the remainder of the day.
Based on the information obtained the allegations are found to be unsubstantiated. A finding of UNSUBSTANTIATED means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted, and a copy of this report was provided along with copies of the Appeal Rights were provided.

A Notice of Site visit was given, and the Licensee understands that it must remain posted for 30 days.

SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelli Waters
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2024

LIC9099 (FAS) - (06/04)

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