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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 093606935
Report Date: 09/19/2023
Date Signed: 09/19/2023 01:52:37 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/28/2023 and conducted by Evaluator Soleil Marx
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230828135552
FACILITY NAME:KINDERCARE LEARNING CENTER - FRANCISCO (INF)FACILITY NUMBER:
093606935
ADMINISTRATOR:STAPLES, ROBBFACILITY TYPE:
830
ADDRESS:2220 FRANCISCO DR.TELEPHONE:
(916) 941-0358
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:40CENSUS: 19DATE:
09/19/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Robb StaplesTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Infant sustained multiple bruises while in care
INVESTIGATION FINDINGS:
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On September 19th, 2023 Licensing Program Analyst, Soleil Marx, met with Director, Robb Staples, for the purpose of delivering findings to a complaint investigation alleging that an infant sustained multiple bruises while in care.

During the course of the investigation, LPA interviewed Director, staff, and parent. LPA reviewed records of injury reports and made observations of the classroom environment. It was determined that a staff member failed to check the transparent window on the infant door prior to opening it, which struck an infant that was on the other side of the door, causing two bruises on the infant’s arm. Based on observation, interview, and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Title 22 deficiencies are being cited on LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
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 03-CC-20230828135552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: KINDERCARE LEARNING CENTER - FRANCISCO (INF)
FACILITY NUMBER: 093606935
VISIT DATE: 09/19/2023
NARRATIVE
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The director was informed that this report dated 09/19/2023 documents Type A citations which shall be posted for 30 consecutive days. The director shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted. Report Reviewed with Director, Robb Staples. Appeal rights provided. A notice of Site was given and must remain posted for 30 days.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20230828135552
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - FRANCISCO (INF)
FACILITY NUMBER: 093606935
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/20/2023
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights(a)The licensee shall ensure that each child is accorded the following personal rights:(2)To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
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Director stated that he will add signs on the doors to remind staff and parents to open the door with caution. Director will submit pictures of the signs on the doors to LPA Marx by POC due date.
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Based on interview and record review, the facility did not meet this requirement by a child getting struck by an opening door by a staff member, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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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.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3