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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343603016
Report Date: 06/24/2024
Date Signed: 06/24/2024 12:48:34 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
04/26/2024 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240426133010
FACILITY NAME:KINDERCARE LEARNING CENTER - MACK (PS)FACILITY NUMBER:
343603016
ADMINISTRATOR:PAULA RITTERFACILITY TYPE:
850
ADDRESS:4920 MACK ROADTELEPHONE:
(916) 428-1880
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:68CENSUS: 37DATE:
06/24/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Dana MatthewsTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff handled child in a rough manner causing injury.
Staff did not follow reporting requirements.
Staff did not keep the facility clean or sanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative,Dana Matthews,to deliver the findings of the complaint alleging above allegations. During the investigation, LPA inspected the facility, interviewed the staff, interviewed the victim child and reviewed facility’s records. LPA interviewed the victim child, which identify and confirmed the staff, that lifted the child with hand and caused injury. The staff interviewed, who stated that staff offered hand to the child and for rest of the day, the child was avoiding to use the arm. From staff interviews, it was found that the incident happened in the morning time, before lunch and nap time. It was found that the class teacher and assistant director observed the child not using and was avoiding to use the arm for rest of the day. It was found that the facility did not notify the parent about the incident to the parents. During LPA inspections, LPA observed the carpet in classroom has stains, trash cans debry around them, cart used to transport food was dirty. Based on LPA 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.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
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 4
Control Number 03-CC-20240426133010
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: 06/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/25/2024
Section Cited
CCR
101223(a)(2)
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To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced during the investigation, it was found that a staff member pulled the child from ground from child’s arm, causing injury.
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Facility representative agreed to conduct staff training to all staff about safe handling children and their personal rights.
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 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: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 03-CC-20240426133010
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: 06/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/26/2024
Section Cited
CCR
101212(f)
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The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement is not met as evidenced during the investigation, it was found that a child showed signs of being injured and
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Facility representative agreed to conduct training to all staff regarding reporting requirements.
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the facility did not inform the parent of the child in timely manner. This poses a potential Health and Safety risk to children in care.
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Type B
07/26/2024
Section Cited
CCR
101238(a)
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The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement is not met as evidenced during the investigation, LPA observed the facility carpets were dirty, trash cans had debry,
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Facility representative agreed to conduct a deep cleaning for each room and will be replacing the items that can not be cleaned.
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food carts were dirty. 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: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
04/26/2024 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240426133010

FACILITY NAME:KINDERCARE LEARNING CENTER - MACK (PS)FACILITY NUMBER:
343603016
ADMINISTRATOR:PAULA RITTERFACILITY TYPE:
850
ADDRESS:4920 MACK ROADTELEPHONE:
(916) 428-1880
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:68CENSUS: DATE:
06/24/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Dana MatthewsTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not handle food in a safe or healthful manner.
Staff did not ensure that child's toileting needs were met.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gagandeep Singh met with the facility representative,Dana Matthews, to deliver the findings of the complaint alleging above allegations.
During the investigation, LPA inspected the facility multiple times, interviewed the staff and interviewed the reporting party. During investigation, LPA observed the food being stored and prepared in the kitchen area of the facility. LPA did observed the food was stored with lids to prevent any contamination. LPA observed the staff take separate cart full of food for each classroom. During inspection and interviews, LPA did not obtain any evidence to that the staff is not changing diapers or preventing children to use restroom. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4