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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343603016
Report Date: 06/25/2025
Date Signed: 06/25/2025 05:22:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/08/2025 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250408112239
FACILITY NAME:KINDERCARE LEARNING CENTER - MACK (PS)FACILITY NUMBER:
343603016
ADMINISTRATOR:DANA MATTHEWSFACILITY TYPE:
850
ADDRESS:4920 MACK ROADTELEPHONE:
(916) 428-1880
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:68CENSUS: 26DATE:
06/25/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Michelle GuardunoTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff did not prevent children in care from causing injuries to another child in care.
Staff is not ensuring that daycare child is provided a safe environment while in care.
Staff did not report incident report incident to daycare child's responsible party.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative, Michelle Guarduno, regarding the complaint investigation.

During the investigation, LPA inspected the facility, conducted interviews and reviewed the records. During the investigation, it was found that there was a child in care, which had interactions with other children that caused injuries. The facility was unable to provide the evidence of informing the parent about the interactions/incidents. Based on LPA’s observations and interviews which were conducted and record review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, are being cited on the attached LIC 9099D. Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
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 3
Control Number 03-CC-20250408112239
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - MACK (PS)
FACILITY NUMBER: 343603016
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/26/2025
Section Cited
CCR
101223(a)(2)
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The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced through staff interviews,
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The facility has conducted the training for all staff for supervison. Facility will submit the sign in sheet for staff attended the training.
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it was found that a child sustain injuries while in care over the period of time and staff was unable to prevent the injuries. This poses an immediate health and safety 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: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20250408112239
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - MACK (PS)
FACILITY NUMBER: 343603016
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/25/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/11/2025
Section Cited
CCR
101226.3(b)
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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 through
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Facility agreed to conduct the training for all staff about procedures of filling the incident reports and informing the parents or authorized representatives.
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staff interviews and record review, that the facility did not reported the child related incidents to the child’s parent. This poses a potential Health and Safety 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: Jeevun Birk-Miller
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3