Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364812754
Report Date: 08/23/2018
Date Signed: 08/23/2018 11:06:26 AM


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 ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/13/2018 and conducted by Evaluator Patricia Berry
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20180813164858
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364812754
ADMINISTRATOR:JENNIFER JOHNSONFACILITY TYPE:
850
ADDRESS:11249 BASELINE AVENUETELEPHONE:
(909) 581-0944
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:90CENSUS: 48DATE:
08/23/2018
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Jennifer Johnson/DirectorTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Staff failed to properly observe day-care child with illness
Facility operates out of ratio
Staff failed to properly report incident
INVESTIGATION FINDINGS:
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Licensing program analyst (LPA) Patricia Berry conducted an unannounced subsequent complaint investigation to deliver final findings. LPA met with director, toured facility and took census.

In regard to allegation: Staff failed to properly observe day-care child with illness, Director stated there is one child #1 who does have febrile seizures. Director stated according to her investigation, a staff member was notified by parent 7/31 that her child had his immunizations on 7/27 and was not feeling well. Director stated the staff member did not relay the message to the afternoon staff member. Director stated both staff members stated child #1 was acting normal, eating good, playing well and was not flushed and seemed happy all day. Director stated at around 5:05 child #1 seemed like he was getting angry at another child who was bothering him, however, the child was clenching his fists because he was having a seizure.
(Cont on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 233-3964
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2018
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 5
Control Number 09-CC-20180813164858
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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364812754
VISIT DATE: 08/23/2018
NARRATIVE
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The director stated 911 was called as well as the parents. Director stated she was informed by paramedics child #1 had a 104.0 fever. Director stated both staff stated to her they did not observe child #1 at any time to have a fever, however, director stated staff did not check the child’s temperature at all during that day. Therefore, due to lack of communication among staff; staff failed to properly observe ill child #1, LPA has determined staff failed to properly observe daycare child with illness to be Substantiated.

In regard to allegation: Facility operates out of ratio, Director stated the facility is not out of ratio. Director stated ratios are always maintained throughout the day. However, LPA obtained information that in the morning rush hour 8:00 AM-10:00 AM sometimes there are 13 to 15 children with 1 teacher for a time span of 2 to 5 minutes. Title 22 regulations states the ratio is 1 teacher to 12 children. Therefore, based on the information obtained, the facility is out of compliance, and LPA has determined allegation facility operates out of ratio to be Substantiated.

In regard to allegation: Staff failed to properly report incident, An incident that occurred on 7/31 regarding a child who had a seizure was not reported to community care licensing. Director is required to report this type of unusual incident within 24 hours, therefore, the facility is out of compliance. LPA has determined the allegation staff failed to properly report incident to be Substantiated.

Based on LPA’s observations and interview/s which were conducted and review/s, the preponderance of evidence standard has been met, therefore the above allegation/s are found to be SUBNSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D

Appeal rights were issued and discussed.

Exit interview conducted with director and report given.

Notice of site visit issued.

Acknowledgement of receipt issued.

Confidential names list provided.

SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 233-3964
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2018
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 09-CC-20180813164858
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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364812754
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2018
Section Cited
HSC
101216.3(a)
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Teacher – Child Ratio. There shall be a ratio of one teacher supervising no more than 12 children in attendance except as specified in (b) and (c). This requirement was not met as evidence by LPA obtained information that in the morning
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Director understands that ratios need to be met. Director stated she will provide a plan to ensure ratios will be meet at all times and send to CCL by 8/31/18.
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rush hours 8:00 AM-10:00 AM sometimes there are 13 to 15 children in the classroom with 1 teacher for a time span of 2 to 5 minutes.

This poses a potential risk to the Health and Safety of children in care.
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Type B
08/31/2018
Section Cited
HSC
101212(d)(1)(C)
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Reporting Requirements. Any unusual incident or child absence that threatens the physical or emotional health or safety of a child shall be reported to the Department within 24 hours of the occurrence. This requirement was not met as evidence by child had a seizure
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Director gave LPA unusual incident report for 7/31 incident. Director will send written statement of acknowledgement, understanding and compliance to regulation 101212(d)(1)(C) and send copy of written statement to CCL by 8/31/18.
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on 7/31 and the unusual incident was not reported to licensing.
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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: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 233-3964
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2018
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 09-CC-20180813164858
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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364812754
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/31/2018
Section Cited
CCR
101216(a)
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Personnel Requirements (a) Child care center personnel shall be competent to provide the services necessary to meet the individual needs of children in care and shall at all times be employed in numbers sufficient to meet those needs. This requirement was not met as
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Director immediately called 911 and parent. Director immediately had a staff meeting with her staff to ensure proper communications are met between staff and parents on 7/31/18. Director stated she will provide a plan on how to communicate more effectively with parents when management
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evidence by LPA obtained information that there was a lack of communication among staff resulting in staff failed to properly observe ill child.
This poses an immediate risk to the Health and Safety of children in care.
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is or is not at facility and send a copy of the plan to CCL by 8/31/18.
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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: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Patricia BerryTELEPHONE: (951) 233-3964
LICENSING EVALUATOR SIGNATURE:

DATE: 08/23/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2018
LIC9099 (FAS) - (06/04)
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