Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364812754
Report Date: 09/23/2016
Date Signed: 09/23/2016 02:32:48 PM


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
08/26/2016 and conducted by Evaluator Kim Leung
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20160826132248
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364812754
ADMINISTRATOR:JACLEEN RUCKERFACILITY TYPE:
850
ADDRESS:11249 BASELINE AVENUETELEPHONE:
(909) 581-0944
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:90CENSUS: 41DATE:
09/23/2016
UNANNOUNCEDTIME BEGAN:
01:52 PM
MET WITH:Jacleen RuckerTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Lack of supervision resulting in child being repeatedly injured

Facility failed to report on child's injuries
INVESTIGATION FINDINGS:
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Licensing Program analyst (LPA) Kim Leung returned to the facility to continue investigating the above allegations. Upon arrival, LPA met with facility director Jacleen Rucker and stated the purpose of the visit. It was alleged that facility failed to supervised children resulting in a child being repeatedly bitten, scratched and hit by other children while attending the facility. It was further alleged that facility failed to report on the child's injuries when the child received a bloody blistered lip and a scratch on the back. Records including incident reports were reviewed, interviews were conducted, program activities and teacher-child interactions were observed during the investigation process. The Incident/Accident Reports for Parent/Guardian revealed that the child was bitten twice on different days by other children while having disagreement with the children; had bumped into another child while running in the activity room; the child fell and hit the mouth on the playground; fell off the library couch and hit the forehead against a Lego table; received a blister on the finger from playing with the blocks; and received a scratch on the arm from another child by accident.

(TO BE CONTINUED ON NEXT PAGE)
Inconclusive
Estimated Days of Completion:
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2016
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 2



Control Number 09-CC-20160826132248
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: 09/23/2016
NARRATIVE
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During the investigation process, there is not a preponderance of evidence to support that the child received bloody blistered lip or scratch on the back from the facility. There is also not a preponderance of evidence to support that the injuries the child received including those documented on the incident reports were a result of lack of supervision.

Based upon the information gathered, there is not a preponderance of evidence to either support or dismiss the allegations. The above allegations are therefore ruled inconclusive at this time.

An exit interview was conducted with Ms. Rucker, Notice of Site Visit was issued and must be posted for 30 days. A copy of this report was provided to the facility.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Anita HiseTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Kim LeungTELEPHONE: (951) 529-4713
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2016
LIC9099 (FAS) - (06/04)
Page: 2 of 2