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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334809083
Report Date: 09/21/2023
Date Signed: 09/21/2023 03:06:16 PM


Document Has Been Signed on 09/21/2023 03:06 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334809083
ADMINISTRATOR:TARA MARTINEZFACILITY TYPE:
830
ADDRESS:610 E. NUEVO ROADTELEPHONE:
(951) 943-6476
CITY:PERRISSTATE: CAZIP CODE:
92571
CAPACITY:24CENSUS: DATE:
09/21/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Tara MartinezTIME COMPLETED:
03:15 PM
NARRATIVE
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On September 21, 2023 at 1:30 pm, Licensing Program Analyst (LPA) Jessica Rubio arrived unannounced to the facility to conduct a case management visit due to an unusual incident report received for an incident that was brought to the attention of Director Tara Martinez on 8/15/2023, reporting that staff (S1) restricted a child (C1's) movement at nap time by covering C1 with a blanket and tucking the blanket under the feet of the cot. This incident is currently being investigated under Complaint #:10-CC-20230913125551 and will be addressed at the conclusion of that complaint. After learning of the incident, Director placed S1 on administrative leave on 8/16/2023 pending investigation.

The same unusual incident report also reported that through further investigation into S1, the same staff, S1, also laid a different child (C2) in a cot at naptime, bumping C2's face and causing C2 to sustain a mark between C2's lip and nose. LPA met with Director Tara Martinez, who confirmed that through an internal investigation brought on by the 8/15/2023 incident, it was determined that S1 forcefully laid C2 down on the cot, bumping C2's face on the corner of the cot causing injury to C2. As a result of the findings above, S1 was terminated as of 8/18/2023 and was notified of the termination on 8/22/2023. Director stated she informed parents of C1 and C2 of the incidents and the termination of S1.

LPA determined that the facility was in violation of Title 22 Regulation Section 101223 (a)(3) Personal Rights. See LIC 809 for Type A cited deficiency.

Due to the Type A citation, an LIC 9224 was provided and Director was informed signed copies must remain in the children's files and be provided to any new enrollees for 12 months

An exit interview was conducted, a copy of this report, along with the LIC 811 (Confidential Names List) and appeal rights were reviewed with and provided to Director Tara Martinez. A notice of site visit was also provided and must remain posted for 30 days.

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M RubioTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2023
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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Document Has Been Signed on 09/21/2023 03:06 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 334809083

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/22/2023
Section Cited
CCR
101223(a)(3)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain... or other actions of a punitive nature...
This requirement was not met as evidenced by:
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S1 has been terminated effective 8/18/2023. S1 was formally informed of termination on 8/22/2023. Director provided documentation to LPA.
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Based on self reported information, that S1 handled child in a rough manner by forcing C2 to lay down, causing injury to C2 which posed an immediate health, safety, and or 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.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 255-4093
LICENSING EVALUATOR NAME: Jessica M RubioTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:
DATE: 09/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/21/2023
LIC809 (FAS) - (06/04)
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