Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198003115
Report Date: 01/11/2019
Date Signed 01/14/2019 08:06:06 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/18/2018 and conducted by Evaluator Ketki Desai
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20181218145800
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003115
ADMINISTRATOR:GARCIA, MELISSAFACILITY TYPE:
830
ADDRESS:1175 VIA VERDETELEPHONE:
(909) 592-2220
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:44CENSUS: 15DATE:
01/11/2019
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Director Garcia Melissa TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff inappropriately handled daycare child
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Ketki Desai and Emiko Bell conducted an unannounced follow-up complaint inspection regarding the above allegation. Today’s inspection was conducted in order to provide the findings of a Complaint investigation.
Upon arrival, LPA met with Assistant Director Angel Haili, who guided LPAs on a tour of the facility in order to take census. Director Melissa Garcia arrived at 9:30 A.M.

In the Infant A room, there were 2 staff with 5 infants; in Infant B, there was 1 staff with 4 infants; and in the Toddler room, there were 2 staff with 6 infants. Staff-infant ratio was met.

During the investigation, LPA conducted interviews with six staff members and three parents and obtained copies of documentation regarding the incident.

Continued - Page 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
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 6
Control Number 33-CC-20181218145800
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 198003115
VISIT DATE: 01/11/2019
NARRATIVE
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The allegation is regarding an incident which occurred on 12/11/18, when the class was doing art and Staff #1 pulled paper away from Child #1. Child #1 then began reaching for paint and Staff #1 became upset and pulled the chair out from underneath Child #1, which made Child#1 fall on their knees. When Child #1 began to cry, Staff #1 said, “You are okay. Get up.”

Based upon the information as stated above, the Department finds that the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22, Division 12, Chapter 1, Article 06. Continuing Requirements, Section 101223 "Personal Rights" is being cited on the attached LIC 9099D.


Upon receipt, the Licensee shall post the Notice of Site Visit and this Licensing report. This report and the Notice of Site Visit shall be posted for thirty (30) consecutive days. Failure to maintain posting as required will result in a $100 civil penalty. A copy of this report shall be provided to the parents/guardians of the children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parents/guardians of any children newly enrolled at the facility for the next twelve (12) months. The LIC 9224 Acknowledgement of Receipt of Licensing Reports must be maintained in each child's file immediately upon receipt from the parent. LPA provided Licensee with a complete copy of the LIC 9224 Acknowledgement of Receipt of Licensing Report.



An exit interview has been conducted with Director Melissa Garcia, and a copy of this report has been signed by and provided to Director Melissa Garcia. Appeal Rights procedures were also provided and explained to the Director.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 33-CC-20181218145800
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 198003115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/15/2019
Section Cited
CCR
101223(a)(1)
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Personal Rights:
This requirement is not met as evidenced by: on 12/11/18, staff #1 made an inappropriate comment to child#1. This poses an immediate risk to the Heath and Safety of children in care
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Facility staff shall watch a Video on Personal Rights posted on the department website and Director to conduct training on Personal Rights with the all the staff. Submit the training agenda and Sign in sheets to the LPA by the due date.
Type A
01/15/2019
Section Cited
CCR
101223(a)(3)
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Personal Rights
This requirement is not met as evidenced by: on 12/11/18, staff #1 pulled a chair out from underneath child #1. This poses an immediate risk to the Health and Safety of the children in care. A Civil Penalty of $250 has been assessed for a repeat
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Facility staff shall watch a Video on Personal Rights posted on the department website and Director to conduct training on Personal Rights with the all the staff. Submit the training agenda and Sign in sheets to the LPA by the due date.
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violation from 12/7/18.
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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: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/18/2018 and conducted by Evaluator Ketki Desai
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20181218145800

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003115
ADMINISTRATOR:GARCIA, MELISSAFACILITY TYPE:
830
ADDRESS:1175 VIA VERDETELEPHONE:
(909) 592-2220
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:44CENSUS: 15DATE:
01/11/2019
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Director Garcia Melissa TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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2
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9
Facility failed to properly notify authorized representative of incident
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Ketki Desai and Emiko Bell conducted an unannounced follow-up complaint inspection regarding the above allegation. Today’s inspection was conducted in order to provide the findings of a Complaint investigation.
Upon arrival, LPA met with Assistant Director Angel Haili, who guided LPAs on a tour of the facility in order to take census. Director Melissa Garcia arrived at 9:30 A.M.

In the Infant A room, there was 1 staff with 5 infants; in Infant B, there was 1 staff with 4 infants; and in the Toddler room, there were 2 staff with 6 infants. Staff-infant ratio was met.

During the investigation, LPA conducted interviews with one staff member, two parents and the Reporting Party

Continued - Page 2
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
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 6
Control Number 33-CC-20181218145800
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 198003115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/11/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/18/2019
Section Cited
CCR
101212
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Reporting Requirements:
This requirement is not met as evidenced by: Facility didn't report an incident to the parent which occured on 12/11/18 but reported on 12/17/18. This possess a potential risk to Health and Safety of the children in care
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Facility to watch training video for Reporting requirement and Director to submit a plan to LPA how the reporting requirements shall be met and submit the signed copies to the LPA by the due date.
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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: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 33-CC-20181218145800
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 198003115
VISIT DATE: 01/11/2019
NARRATIVE
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The allegation is regarding an incident which occurred on 12/11/18, when the class was doing art and Staff #1 pulled paper away from Child #1. Child #1 then began reaching for paint and Staff #1 became upset and pulled the chair out from underneath Child #1, which made Child#1 fall on their knees. When Child #1 began to cry, Staff #1 said, “You are okay. Get up.” Though the facility reported this incident to the Department within the required timeframe of 24 hours, the parent of Child #1 was not notified until six days after the occurrence of the incident. The explanation provided was that an authorized representative of Child #1 was picking Child #1 up and the facility did not feel comfortable disclosing the incident to the authorized representative, as the authorized representative is not the parent. On 12/17/18, the Center then phoned the parent of Child #1 and inquired as to whether the parent would be picking up the child, as the Center needed to speak with the parent about an incident which had occurred. On 12/17/18, the parent picked up Child #1 and was then informed of the incident which had occurred on 12/11/18.

According to Title 22 regulations, the parent should have been notified "As soon as possible". Based on this information, the Department finds that the preponderance of evidence standard has been met; therefore, the above allegation is found to be Substantiated.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. reasonable basis. An exit interview was conducted Director Melissa Garcia.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3439
LICENSING EVALUATOR NAME: Ketki DesaiTELEPHONE: (323) 981-3351
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2019
LIC9099 (FAS) - (06/04)
Page: 6 of 6