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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198003098
Report Date: 11/18/2021
Date Signed: 11/18/2021 01:08:40 PM

Unsubstantiated


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
10/08/2021 and conducted by Evaluator Thelma Razo
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20211008141849
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003098
ADMINISTRATOR:MARGIE ZARATEFACILITY TYPE:
840
ADDRESS:3443 NOGALESTELEPHONE:
(626) 965-9611
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY:42CENSUS: 0DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:Margie Zarate, DirectorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Lack of supervision resulting in inappropriate interactions between day care children while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Thelma Razo conducted a subsequent complaint inspection to deliver findings on the allegation of "Lack of supervision resulting in inappropriate interactions between day care children while in care. Specifically, it was alleged that on 09/05/21, Child #1 hit and called Child #2 (C2) stupid. Also, there was an incident where Child #3 (C3) spit on C2.

During this investigation, interviews were conducted with 5 staff, 3 parents and 6 children. LPA obtained IncidentAccident Report for Parent/Guardian for the month of September and October 2021, a total of 20 incidents involving children.
Investigation has revealed that there was an incident with C1 who was holding a scissor and was yelling at the students. Per Staff #1 (S1), the class was cleaning up the room in transition to playground. S1 took the scissor from C1 to put it away and asked C1 to have a seat. S1 was three steps away when C1 punched C2 on the back. S1 said this was unexpected and S1 redirected C1 and checked on C2. Staff #2 was in the classroom but did not actually witnessed the incident because S2 was helping another child. There were inconsistencies on the statements as to the date when the incident has happened. LPA reviewed written incident reports and there was no incident that happened on the alleged date of the incident (9/5/2021)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
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 5
Control Number 33-CC-20211008141849
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: 198003098
VISIT DATE: 11/18/2021
NARRATIVE
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but found one that involved C1 and C2 which happened on 10/6/2021, the one that was mentioned above. No other incidents were written that involved C1 and C2 together. Investigation has also revealed that based on written incident report, on 9/23/2021, C3 spit on C2 in the playground and there were 3 staff that day. According to Staff #2, C3 was told that it was not okay and was asked to put on the mask.

Parents interviewed did not disclose any concern regarding the care being provided and the staff. Various interviews did not disclose that there was a lack of supervision resulting in inappropriate interactions between day care children.

LPA observed 3 staff supervising 26 children during the inspection on 10/13/2021 and 3 staff supervising 24 children on 10/28/2021.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is unsubstantiated.

Exit interview conducted and report was reviewed with Director Margie Zarate.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
10/08/2021 and conducted by Evaluator Thelma Razo
PUBLIC
COMPLAINT CONTROL NUMBER: 33-CC-20211008141849

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
198003098
ADMINISTRATOR:MARGIE ZARATEFACILITY TYPE:
840
ADDRESS:3443 NOGALESTELEPHONE:
(626) 965-9611
CITY:WEST COVINASTATE: CAZIP CODE:
91792
CAPACITY:42CENSUS: 0DATE:
11/18/2021
UNANNOUNCEDTIME BEGAN:
12:12 PM
MET WITH:Margie Zarate, DirectorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Facility is not reporting incident(s
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Thelma Razo conducted a subsequent complaint inspection to deliver findings on the allegation of "Facility is not reporting incident(s)". Specifically, there were two incidents wherein parent(s) were not notified of the incident that involved their child.
During this investigation, interviews were conducted with 5 staff, 3 parents and 6 children.
Facility has a Family Handbook which is a guide to the center's programs and operational procedures. It has indicated that if the child is injured, Incident/Accident Report will be given at pick up time. Staff interviewed have disclosed that an incident report is written manually in duplicate, one is given to the parent/guardian after they sign it, the duplicate copy is kept by the center.
Staff #3 (S3) has admitted that S3 forgot to write an incident report on the day that Child #3 (C3) spit on Child #2 at the playground on 9/23/2021. S3 wrote the report the following day.
LPA reviewed incident reports for the month of September and October of 2021, a total of 20 reports. LPA observed 7 out of 20 reports did not have signature of parent/guardian, three of the incidents required administration of first aid by staff. There was an incident that happened on 10/6/2021 involving Child #1(C1) and Child #2 (C2) wherein C1 hit and told C2 to "shut up". An incident report was written for C1 but not for C2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 33-CC-20211008141849
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: 198003098
VISIT DATE: 11/18/2021
NARRATIVE
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Based on LPA’s observations and interviews which were conducted and record review, the preponderance of the evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on the attached LIC9099D.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Director Margie Zarate.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 33-CC-20211008141849
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: 198003098
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/29/2021
Section Cited
CCR
101226(a)(2)
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Health-Related Services. In the case of less serious injuries including, but not limited to, minor cuts, scratches and bites from other children requiring assessment and/or administration of first aid by staff, the licensee shall document the injury in the child's record and notify the child's authorized representative of the nature of the injury when
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Director is to submit to LPA by due date, a plan to address the reporting requirement as indicated on Section 101226(a)(2).
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the child is picked up from the center. This requirement was not met as evidenced by: Staff admitted forgetting to write an incident report and wrote it the following day. Seven out of 20 incident reports were not signed by parent/guardian, three of the incidents required administration of first aid by staff. This poses a potential health and safety risk to the children 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: Brandi VanOosten
LICENSING EVALUATOR NAME: Thelma Razo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5