<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334804329
Report Date: 11/25/2024
Date Signed: 11/25/2024 12:18:38 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, 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
10/01/2024 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20241001151849
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804329
ADMINISTRATOR:THERESA SALLEYFACILITY TYPE:
850
ADDRESS:11961 PERRIS BLVDTELEPHONE:
(951) 243-6558
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:72CENSUS: 40DATE:
11/25/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Theresa SalleyTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Staff does not ensure adequate supervision resulting in day care child being bitten.
- Staff did not inform child’s parent of incident.

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On date and time listed, Licensing Program Analyst (LPA) Sumayya Habeebulla arrived unannounced at the facility and met with Facility Director to deliver the investigative findings for the above stated allegations.

During the investigation, interviews were conducted with Facility Director and other pertinent parties. LPA also obtained copies of pertinent records that included: facility roster, ouch reports, and pictures.





See LIC 9099C for continuation.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
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 6
Control Number 10-CC-20241001151849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804329
VISIT DATE: 11/25/2024
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
26
27
28
29
30
31
32
As per the interviews conducted, interviews revealed that C1 has got bitten at the facility various times but none of the staff have witnessed the incident and the incident was not reported to parent during pick up time. In November of 2023, facility was notified by parent of C1 that they had observed a bite mark on the child and facility was unaware of it and an ouch report was not provided during pick up time. In late February of 2024, C1 had multiple bite marks on them and again this was observed by the parent upon arriving at home. Parent contacted facility representative who assured parent that staff will be trained on ensuring proper supervision. An ouch report was provided after the parent notified facility. There were two more incidences of C1 being bitten in July and August and each time the facility staff were unaware of the incident and failed to notify parent and an ouch report was not provided on the day of the incident.

Based on LPAs observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, 101438.1 Infant Care General Sanitation (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC 9099D.

Exit interview conducted. Appeal rights discussed and provided along with a copy of this report was provided to the Licensee on this date.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/01/2024 and conducted by Evaluator Sumayya Habeebulla
COMPLAINT CONTROL NUMBER: 10-CC-20241001151849

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804329
ADMINISTRATOR:THERESA SALLEYFACILITY TYPE:
850
ADDRESS:11961 PERRIS BLVDTELEPHONE:
(951) 243-6558
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:72CENSUS: DATE:
11/25/2024
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
- Facility operating out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On date and time listed, Licensing Program Analyst (LPA) Sumayya Habeebulla arrived unannounced at the facility and met with Facility Director to deliver the investigative findings for the above stated allegations. During the investigation, interviews were conducted with Facility Director and other pertinent parties. LPA also obtained copies of pertinent records that included: facility roster, ouch reports, and pictures.

As per the interviews conducted, and LPAs observation facility maintains a ratio of 12 children to one staff. During the visit conducted by LPA on 10/03/24, LPA observed 24 children with two staff in the 2’s classroom. Interviews revealed that staff are aware not to exceed the 12:1 ratio and if additional assistance was required staff reaches out to administration to provide the extra hand.

See LIC 9099C for continuation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 10-CC-20241001151849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804329
VISIT DATE: 11/25/2024
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
26
27
28
29
30
31
32
From the information received through interviews with all pertaining parties, the above allegation cannot be verified. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted. Appeal rights discussed and provided along with a copy of this report was provided to the Licensee on this date.

The Notice of Site Visit (LIC 9213) must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Some of the report pages had to be signed by Assistant Director Donna Shallow horn since LPAs computer did not capture the signatures of the facility Director and the facility director had to leave for pick up.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 10-CC-20241001151849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804329
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/26/2024
Section Cited
CCR
101229(a)(1)
1
2
3
4
5
6
7
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful, and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Facility Director agrees to provide training on personal rights to staff and submit a statement with staff signatures acknowledging the training.
8
9
10
11
12
13
14
Based on interview and record review the facility did not comply with the section cited above in ensure a safe and comfortable environment is provided for all children in care. Staff was unaware of the injuries/bite marks that were found on the child.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 10-CC-20241001151849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804329
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/03/2024
Section Cited
CCR
101226.3(b)
1
2
3
4
5
6
7
Observation of the Child
(b) Any unusual behavior, any injury or signs of illness requiring assessment and/or administration of first aid by staff shall be reported to the child's authorized representative and recorded in the child's record.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Facility Director agrees to provide a written report to the department by the POC due date explaining the revised procedure of reporting to parents of any incidences of injury of the child at the facility.
8
9
10
11
12
13
14
Based on interview and record review the facility did not comply with the section cited above in informing the parent of the injury during pick up time.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6