Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364812756
Report Date: 10/27/2017
Date Signed: 10/27/2017 04:30:28 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
10/24/2017 and conducted by Evaluator Patricia Berry
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20171024152856
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364812756
ADMINISTRATOR:JACLEEN RUCKERFACILITY TYPE:
830
ADDRESS:11249 BASELINE AVENUETELEPHONE:
(909) 581-0944
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:40CENSUS: 28DATE:
10/27/2017
UNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH:Ashley Rawls/Assistant DirectorTIME COMPLETED:
04:50 PM
ALLEGATION(S):
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Facility staff fail to keep the facility clean
INVESTIGATION FINDINGS:
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Licensing program analyst (LPA) Patricia Berry conducted an unannounced complaint investigation in regards to the above allegation "Facility staff fail to keep the facility clean". LPA toured facility and took a census. LPA observed in infant room (toddler #1) and throughout the facility the carpets and trash bins need cleaning. Assistant director Ashely Rawls stated the carpets were cleaned October 2, 2017 and did provide proof the carpets were cleaned in October. Regulation 101238 ((a) specifically states the child care center shall be clean, safe and sanitary and in good repair at all times.

Based on the above information and LPA’s observations the preponderance of evidence standard has been met, therefore the above allegation/s is found to be SUNSTANTIATED. California Code of Regulations, (Title 22, divisions & chapter number) are being cited on the attached LIC 9099D.”)

Exit interview conducted with Ashley Rawls. Appeal rights and report given. Notice of Site Visit Issued.

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: 10/27/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 09-CC-20171024152856
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: 364812756
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/27/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/02/2017
Section Cited
CCR
101238(a)
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Buildings and Grounds. The child care center shall be clean, safe, sanitary and in good repair at all times.

"This poses a potential risk to the Health and Safety of the children in care".
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Assistant director immediately called the carpet cleaning agency to clean the carpets on 10/27/17. The assistant director also has staff working on cleaning all the trash bins in the classrooms. Assistant director stated she will send proof of both carpets cleaned and trash bins cleaned to CCL by 11/2/17.
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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: 10/27/2017
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2017
LIC9099 (FAS) - (06/04)
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