Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 376600788
Report Date: 06/02/2017
Date Signed 06/02/2017 03:46:26 PM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/17/2017 and conducted by Evaluator Celina Damian
PUBLIC
COMPLAINT CONTROL NUMBER: 20-CC-20170417093225
FACILITY NAME:KINDERCARE LEARNING CENTER - PASEO LADERAFACILITY NUMBER:
376600788
ADMINISTRATOR:ANA KINGFACILITY TYPE:
850
ADDRESS:1101 PASEO LADERATELEPHONE:
(619) 482-1800
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:90CENSUS: 51DATE:
06/02/2017
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Celia FrancoTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Lack of care and supervision - Children were allowed to unsafely ride a bike resulting in a child falling and sustaining an arm fracture. Fall was not witnessed by staff.

Personal Rights- Facility failed to obtain proper medical care after a serious arm injury
INVESTIGATION FINDINGS:
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LPA Damian conducted a complaint inspection on this date. LPA met with Assistant Director Celina Franco. There were 51 children in care. The purpose of the visit is to deliver finding regarding the above allegations.

Based upon staff and witness interviews, LPA observation and documents and other evidence gathered the preponderance of evidence standard has been met. On 04/13/2017 at approximately 10:30AM during outside play time, two children were riding on a two seater bike while another child unsafely pushed the bike. At some point the child seated in the back seat fell from the bike. The cause of the fall is unclear as staff did not witness the actual fall. After the fall, staff attended to the child, first aid was administered and parent was notified to pick up child. Child's arm was placed in a sling. While making arrangements for pick up, a different staff called parent and informed that the child was able to move their arm and only appeared to be a little sore. Child was not picked up until the end of the day at approximately 4PM. When child was picked up arm appeared to be "hanging", child was in pain and sling had been removed. Parent took the child to the doctor where the doctor diagnosed the child with a fracture of the right humerus.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Celina DamianTELEPHONE: 619-767-2200
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2017
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 3



Control Number 20-CC-20170417093225
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KINDERCARE LEARNING CENTER - PASEO LADERA
FACILITY NUMBER: 376600788
VISIT DATE: 06/02/2017
NARRATIVE
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This constitutes a lack of care and supervision and is a violation of children's personal rights. Therefore, the above allegations are substantiated.

AB633**** Please refer to page 2 for deficiency that was cited for correction per CCR, Title 22, Division 12, Chapter 1 regulations. Provided and discussed appeal rights. Notice of Site Visit posted during visit and must remain posted for 30 Days. Furthermore, upon receipt, Licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. An Acknowledgment of Receipt of Licensing Reports, Form LIC 9224 must be signed and placed in each child’s file. Exit Interview conducted with ***
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Celina DamianTELEPHONE: 619-767-2200
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 3


Control Number 20-CC-20170417093225

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: KINDERCARE LEARNING CENTER - PASEO LADERA
FACILITY NUMBER: 376600788
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/02/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/09/2017
Section Cited
101229(a)(1)
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Licensee shall provide care and supervision to meet child's needs and no child 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). Staff failed to provide adequate care and visual supervision of children riding bikes therefore resulting in child falling and sustaining arm fractrure.
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Assistant Director states that new playground rules have been implemented and memos have been placed as staff reminders. Only a certain number of bikes and scooters will be allowed for each of three playground areas. Children will be reminded of new rules.
Type A
06/09/2017
Section Cited
101223(a)(2)
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101223(a)(2) Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishings and equipment.
Child in care was injured and facility failed to ensure that child received immediate and proper medical attention.
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Assistant Director states that from now on if a child sustains an injury that appears to be more than a minor injury parent will be called and facility will request that parents come to check on child. A training was held with Health & Safety Coordinator. A copy of training was provided to LPA on this 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: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Celina DamianTELEPHONE: 619-767-2200
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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