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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001828
Report Date: 01/25/2021
Date Signed: 01/25/2021 02:04:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001828
ADMINISTRATOR:CARRERA, TONIFACILITY TYPE:
850
ADDRESS:581 PEABODY ROADTELEPHONE:
(707) 447-7685
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:75CENSUS: 31DATE:
01/25/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Traci MarshallTIME COMPLETED:
01:35 PM
NARRATIVE
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On 1/25/2021 Licensing Program Analyst (LPA) Emilia Grisak conducted an unannounced case management visit and met with Acting Director Traci Marshall. This visit was conducted via tele-inspection due to the Covid-19 State of Emergency. This case management visit is in response to two unusual incidents which were self- reported by the facility to Community Care Licensing (CCL). The first incident took place and was reported to CCL on 12/11/20 in which child C1 was left unattended on the playground after recess. The second incident took place on 12/16/20 and was reported to CCL on 12/17/20 in which staff S1 was reported to have rough handled child C2.

LPA called and interviewed Acting Director Traci Marshall on 12/18/2020 regarding these two incidents. Regarding the incident which took place on 12/11/20, Acting Director stated that all the children came inside after recess at 11am, and approximately two minutes later teacher S2 walked into the classroom and saw C1 in the playground near the play structure. Acting Director stated that C1 was immediately brought inside and was outside alone for two minutes maximum. It was also stated that C1’s teacher, S3, was written up and has received additional training in response to this incident. LPA conducted two staff interviews on 12/28/20 regarding this incident. It was stated by both staff that all children came inside from recess at 11am, and child C1 was observed outside alone approximately one to two minutes later when S2 returned from break.

Regarding the incident which took place on 12/16/20, Acting Director stated that it was reported to her on that date that S1 was observed to have rough handled child C2. Acting Director stated that she did not observe the incident and had the staff who did witness it write out statements. It was stated by Acting Director on 12/18/2020 that S1 was been suspended pending an investigation. LPA conducted interviews with three staff on 12/28/20 regarding this incident. It was stated by staff that S1 was observed to have pushed child C2 in the chest/abdomen area into a chair three times. It was also stated by staff that S1 was observed picking C2 up by the arms and swinging child into the air. It was stated during staff interviews that S1 appeared frustrated and was handling the child too roughly.

SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia GrisakTELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001828
VISIT DATE: 01/25/2021
NARRATIVE
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The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC 9224 to be kept in each child's file.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia GrisakTELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001828
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/25/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/26/2021
Section Cited

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Responsibility for Providing Care and Supervision - No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
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Based on interviews and record review the licensee did not ensure that child C1 was supervised when C1 was left on the playground alone which poses an immediate health and safety risk to children in care.
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Type A
01/26/2021
Section Cited

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Personal Rights. The licensee shall ensure that each child is accorded the following personal rights: To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by:
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Based on interviews and record review the licensee did not ensure that child C2 was treated with dignity when C2 was handled roughly by staff S1 which poses an immediate health, safety, and/or personal 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.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia GrisakTELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3