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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343607712
Report Date: 12/07/2021
Date Signed: 12/07/2021 12:03:48 PM

Document Has Been Signed on 12/07/2021 12:03 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:KINDERCARE LEARNING CENTER - NATOMA (PRESCHOOL)FACILITY NUMBER:
343607712
ADMINISTRATOR:MALHI, PARVEENFACILITY TYPE:
850
ADDRESS:420 NATOMA STATION DR.TELEPHONE:
(916) 353-0687
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 47DATE:
12/07/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria HarlandTIME COMPLETED:
12:30 PM
NARRATIVE
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On December 7th, 2021, Licensing Program Analyst (LPA) Kelly Ferrara conducted a Case Management Inspection and met with Assistant Director Maria Harland. Today's census included 47 preschool children in care with five staff.

LPA received an Unusual Incident Report from the facility regarding an incident that occurred on November 24th, 2021. During today's inspection, LPA interviewed Child #1 and Assistant Director regarding the incident. LPA learned that Child #1 disclosed to their parents that Staff #1 had squeezed their hand and scratched their knuckles while working on handwriting. Assistant Director observed nail marks on Child #1’s right hand when they were fresh and LPA observed the same marks on the child that were healing. Assistant Director stated Staff #1 has been fired from Kindercare Learning Center.

Based on the information received, a Title 22 personal rights violation has occurred. See page 809-D for deficiency cited. Exit interview was conducted and a copy of this report was given to the Assistant Director. Notice of site was given and must remain posted for 30 days.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2021
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 12/07/2021 12:03 PM - It Cannot Be Edited


Created By: Kelly Ferrara On 12/07/2021 at 08:25 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: KINDERCARE LEARNING CENTER - NATOMA (PRESCHOOL)
FACILITY NUMBER: 343607712

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/14/2021
Section Cited
CCR
101223(a)(3)

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Personal Rights (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: Information was received from facility that Staff #1 squeezed and scratched Child #1’s hand. Child #1
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Assistant Director stated Staff #1 has been fired and LPA did not observe them on the premises. LPA advised that it is best practice to have more than one staff in a classroom to ensure accountability. Assistant Director stated she will give staff two scenarios and they will have to write their answer of what they would do.
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 confirmed this incident occurred. This is a health and safety risk to children in care.
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The documents will be signed and sent in to LPA Ferrara by POC due date.

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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:Maria Mayorga
LICENSING EVALUATOR NAME:Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:
DATE: 12/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/07/2021


LIC809 (FAS) - (06/04)
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