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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334804331
Report Date: 05/16/2024
Date Signed: 05/16/2024 02:08:31 PM

Unsubstantiated


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
05/14/2024 and conducted by Evaluator Sumayya Habeebulla
PUBLIC
COMPLAINT CONTROL NUMBER: 10-CC-20240514161943
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804331
ADMINISTRATOR:THERESA SALLEYFACILITY TYPE:
830
ADDRESS:11961 PERRIS BLVDTELEPHONE:
(951) 243-6558
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:24CENSUS: 14DATE:
05/16/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Theresa SalleyTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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- Due to lack of supervision daycare child sustained an injury
INVESTIGATION FINDINGS:
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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, sign in record, pictures of the bruise, pictures of the playground.

On April 25, 2024, complaints were received by the department alleging due to lack of supervision daycare child sustained an injury.

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

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
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-20240514161943
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: 334804331
VISIT DATE: 05/16/2024
NARRATIVE
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The allegation is of due to lack of supervision daycare child sustained an injury. As per the interviews conducted, on the day of the incident, C1 was going up the playground steps for the slide using their arms to climb up. In the process C1’s arm slipped and C1’s face hit on the edge of the stair. Parent was notified and the bruise was iced. As per the interviews, the child resumed with their regular schedule shortly after the incident and was not picked up by parent due to the injury. The incident was witnessed by staff who were supervising the children during outdoor play and were unable to stop it from happening due to how fast it had occurred. An ouch report was provided to the parent during pick up time. Facility records indicate that the attendance for C1 is not consistent and as per staff the absences were not due to the injury. Pictures shared with the department do not show any bruising on the child’s face.

From the information received through interviews with Licensee and other 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.

An exit interview was conducted with Facility Director Theresa Salley, a Notice of Site Visit posted, and a copy of this report was provided to the facility on this date and time.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC9099 (FAS) - (06/04)
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