Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 334804331
Report Date: 01/05/2018
Date Signed 01/05/2018 11:35:46 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/01/2017 and conducted by Evaluator Yolanda Jackson
COMPLAINT CONTROL NUMBER: 09-CC-20171101141001
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
334804331
ADMINISTRATOR:HOPKINS, KIMFACILITY TYPE:
830
ADDRESS:11961 PERRIS BLVDTELEPHONE:
(951) 243-6558
CITY:MORENO VALLEYSTATE: CAZIP CODE:
92557
CAPACITY:24CENSUS: 2DATE:
01/05/2018
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Victoria GonzalezTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Facility staff failed to properly meet child's diapering needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Yolanda Jackson arrived at the facility to conclude the investigation on the above allegation. Initial Visit was 11/08/17. LPA met with Victoria Gonzalez, Assistant Director. LPA conducted interviews. The center could not provide a diaper log, dated 10/30/17, for LPA to verify how the child’s diaper was changed.

It was reported the facility staff failed to properly meet the child’s needs. The Director stated the staff member observed redness on the child’s penis and notified the parent. The parent bought A&D Ointment to the center and the parent signed an Authorization Form so they can apply the cream. The staff member stated they changed the child’s diaper every 2 hours if not sooner. The parent picked up the child from the center and the child was wearing another child’s diaper that had the same initials as the child. The parent supplied diapers for the child. The staff member spoke to the parent at the end of the day and said the diaper rash on the child’s penis had got worse. The parent picked up the child and the child was soaking wet with urine. The parent took the child to the doctor and the baby’s penis was red and swollen.

**CONTINUED ON NEXT PAGE**
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2018
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 09-CC-20171101141001
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 334804331
VISIT DATE: 01/05/2018
NARRATIVE
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From the conflicting information received during the course of this investigation the findings will be deemed Unsubstantiated as the LPA was unable to prove or disprove the above allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did not occur, therefore the allegation is Unsubstantiated.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 784-4200
LICENSING EVALUATOR NAME: Yolanda JacksonTELEPHONE: (951) 201-1991
LICENSING EVALUATOR SIGNATURE:

DATE: 01/05/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2018
LIC9099 (FAS) - (06/04)
Page: 2 of 3