Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 304270397
Report Date: 02/22/2017
Date Signed 02/22/2017 04:10:30 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/23/2016 and conducted by Evaluator Minerva Hundley
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20160923132152
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270397
ADMINISTRATOR:TORRES, BEATRICEFACILITY TYPE:
850
ADDRESS:4601 BEACH BLVD.TELEPHONE:
(714) 994-5610
CITY:BUENA PARKSTATE: ZIP CODE:
90621
CAPACITY:120CENSUS: 60DATE:
02/22/2017
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Ms. TorresTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Supervision: Child sustained unexplained bruising.
INVESTIGATION FINDINGS:
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Complaint Specialist Hundley arrived to the facility to deliver a final report of the investigation, which was conducted by the Department’s IB Investigator. Based on interviews conducted and medical records reviewed the allegation of lack of care and supervision resulting in unexplained injures is substantiated.
In the areas that were evaluated, the facility was not in compliance and violation(s) of the California Code of Regulations, Title 22, Division 12, chapter 1 was observed, discussed and cited at the time of the visit.

During today’s visit CS toured the facility and census was taken. The overall census observed was 10 preschool staff supervising 60 preschool children, and 5 infant staff supervising 16 infant children, 1 school-age staff supervising 12 school-age children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
(Continued on next page.)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
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 4



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/23/2016 and conducted by Evaluator Minerva Hundley
PUBLIC
COMPLAINT CONTROL NUMBER: 06-CC-20160923132152

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
304270397
ADMINISTRATOR:TORRES, BEATRICEFACILITY TYPE:
850
ADDRESS:4601 BEACH BLVD.TELEPHONE:
(714) 994-5610
CITY:BUENA PARKSTATE: ZIP CODE:
90621
CAPACITY:120CENSUS: DATE:
02/22/2017
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Ms. TorresTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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9
Personal Rights
INVESTIGATION FINDINGS:
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Complaint Specialist Hundley arrived to the facility to deliver a final report of the investigation, which was conducted by the Department’s IB Investigator. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12.

During today’s visit CS toured the facility and census was taken. The overall census observed was 10 preschool staff supervising 60 preschool children, and 5 infant staff supervising 16 infant children, 1 school-age staff supervising 12 school-age children. A review of staff criminal clearance records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Inconclusive
Estimated Days of Completion:
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4



Control Number 06-CC-20160923132152
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270397
VISIT DATE: 02/22/2017
NARRATIVE
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PAGE 2

An exit interview was completed. The report was reviewed and discussed.

Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Licensing office within 15 business days. The facility Type A report shall be posted, copies of the report are to be provided to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days, and provide a copy to current and enrolling parents. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file.

THE FACILITY REPRESENTATIVE WAS INFORMED THAT THE 'NOTICE OF SITE VISIT' MUST BE POSTED FOR 30 CONSECUTIVE DAYS. FAILURE TO POST WILL RESULT IN CIVIL PENALTIES OF $100.00. THE 'NOTICE OF SITE VISIT' MUST BE POSTED ON OR ADJACENT TO THE DOOR. FAILURE TO POST TYPE A REPORTS FOR 30 DAYS WILL RESULT IN A CIVIL PENALTY OF $100.00.

E-Learning modules flyer was given and discussed.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 4


Control Number 06-CC-20160923132152

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 304270397
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/22/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/22/2017
Section Cited
101229(a)(1)
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Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1). Child #1 sustained injures while at the day care. Staff were unaware how the child was injured. This poses an immediate Health and Safety risk to the children/clients in care.
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Director stated they will have a staff meeting in regards to personal rights and supervision and will show Learning module on supervision and personal rights in child care. A written plan of correction will be submitted to CCL office.
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A $150.00CP is being assessed per day until corrected.
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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: Rina LopezTELEPHONE: (714) 703-2800
LICENSING EVALUATOR NAME: Minerva HundleyTELEPHONE: (714) 703-2834
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2017
LIC9099 (FAS) - (06/04)
Page: 3 of 4