493001831-6-27-2022-01-CC-AHON-CFTTND-20220628145232

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493001831
Report Date: 06/24/2022
Date Signed: 06/27/2022 09:50:05 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/13/2022 and conducted by Evaluator Yang Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220413105707

FACILITY NAME:	KINDERCARE LEARNING CENTER		FACILITY NUMBER:	493001831
ADMINISTRATOR:	RICHARDSON,KYLIE		FACILITY TYPE:	850
ADDRESS:	6150 STATE FARM DRIVE		TELEPHONE:	(707) 584-0124
CITY:	ROHNERT PARK	STATE: CA	ZIP CODE:	94928
CAPACITY:	96	CENSUS: 29	DATE:	06/24/2022
		UNANNOUNCED	TIME BEGAN:	01:11 PM
MET WITH:	Alexandria "Alex" Pepper, Acting Center Director		TIME COMPLETED:	04:32 PM

ALLEGATION(S):

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-Daycare child was his hit/kicked by another daycare child
-Day care child sustained unexplained injuries while in care

INVESTIGATION FINDINGS:

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An unannounced follow-up complaint investigation visit to the facility was made today by Licensing Program Analyst (LPA), Y. Yang to deliver complaint investigation findings. It was alleged that daycare child C1 was hit/kicked by another daycare child, and it was alleged that daycare child C1 sustained unexplained injuries while in care. Specifically, it was alleged that child C1 developed bruises on their ankles, back, between their legs, and cuts/scratches on their arm and face while at the center.

The LPA met with the facility’s acting center director, Alexandria Pepper (staff S3) today to discuss the investigation findings and a tour of the facility was conducted at 01:15 pm. During the initial investigation visit on 04/20/22, the LPA met with the facility’s former center director, Tiffany Dougherty (staff S1) to discuss the allegations. During the follow-up investigation visit by the LPA on 05/20/22, Dougherty notified the LPA that she was resigning and would no longer be working at this facility effective 05/28/22. As of 05/28/22, Pepper is the facility’s acting center director.
Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

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 3

Control Number 01-CC-20220413105707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 493001831
	VISIT DATE: 06/24/2022

NARRATIVE

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During the initial investigation visit on 04/20/22, the former center director, Tiffany Dougherty (staff S1) was interviewed by the LPA at 11:27am. Dougherty stated that she acknowledges that child C1 sustained minor injuries while at the facility but denies that the injuries were caused by a lack of supervision or any other violation of regulations. Dougherty stated that the facility maintains a ratio of 12 children to 1 teacher. Dougherty stated that children are always supervised while at the center.

During the investigation, the LPA obtained completed “Incident/Accident Report for Parent/Guardian” that were filled out on child C1’s behalf. According to Dougherty, there were 10 incident/accident reports that were completed between August 2021 and April 2022. Dougherty stated that none of the injuries sustained by child C1 required any medical attention. Dougherty stated that all injuries and incidents that occur at the center are documented, and the child’s authorized representative is notified.

Dougherty stated that she believes some of the injuries, bruises, scratches, and/or cuts may have resulted from child C1 roughhousing with his classmates. Dougherty stated she observed child C1 in their classroom and interviewed C1’s teachers. Dougherty stated that she observed child C1 and several of his classmates climbing and jumping off furniture and running in the classroom. Dougherty stated that these activities are prohibited at the center. Dougherty stated that child C1 and several of his classmates were frequently redirected by their teachers. Dougherty stated that she did not believe that child C1 was being targeted or bullied by other children. Dougherty stated that due to staff turnover, children were frequently introduced to new teachers in their classrooms. Dougherty stated that some children responded poorly to the frequent changes.

Dougherty stated that she spoke with the authorized representative(s) of child C1 on several occasions to discuss their concerns and come up with a solution. Dougherty stated that a “Behavior Intervention Plan” was created for child C1 that went in to effect on 04/25/22. Dougherty stated that the plan outlined the targeted behaviors and the steps the center was taking to address the behaviors.

During the investigation, interviews were conducted with staff members S1-S3 on 04/20/22 beginning at 11:27am and S4-S5 on 05/20/22 beginning at 01:11pm and S6-S7 on 06/23/22 beginning at 02:15pm. The staff members that were interviewed corroborated the former center director’s statements. Staff members interviewed stated that they currently do not have any concerns about the level of care and supervision provided at the center.

Continued on LIC9099-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20220413105707

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KINDERCARE LEARNING CENTER	FACILITY NUMBER: 493001831
	VISIT DATE: 06/24/2022

NARRATIVE

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Although it was corroborated that child C1 sustained minor injuries while in care, based on available information and interviews conducted, there was not a preponderance of evidence to prove that the injuries were due to a lack of supervision or any other violation of regulations. Therefore, the allegations are unsubstantiated. All licensing reports are public information and must be made available upon request for at least three years. This report was read and reviewed with the acting center director, Alexandria Pepper. There were no Title 22 deficiencies cited during today's inspection. Appeal rights were provided. The Notice of Site Visit shall be posted for at least 30 days.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2022

LIC9099 (FAS) - (06/04)

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