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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343615313
Report Date: 06/12/2024
Date Signed: 06/12/2024 12:54:14 PM

Document Has Been Signed on 06/12/2024 12:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:KINDERCARE LEARNING CENTER - ELK GROVE FLORINFACILITY NUMBER:
343615313
ADMINISTRATOR/
DIRECTOR:		CHAVEZ, ANGELAFACILITY TYPE:
850
ADDRESS:9250 ELK GROVE FLORIN ROADTELEPHONE:
(916) 714-2772
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 104TOTAL ENROLLED CHILDREN: 104CENSUS: 60DATE:
06/12/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Alejandra ParedesTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On 06/12/2024, Licensing Program Analyst (LPA) Jennie Tedlos met with Substitute Director (SD), Alejandra Paredes to conduct an unannounced case management inspection due to deficiencies. At time of arrival LPA observed 60 children and 8 staff.

Upon conducting record review for the complaint investigation that was initiated on 03/27/24, LPA observed documentation detailing an incident that occurred in February 2024. The documentation revealed that a Teacher (T1) was placed on administrative leave on 3/5/24 and terminated from employment on 3/22/24 for violating children's rights. Staff and parent interviews revealed that T1 forcefully pulled off a child's backpack from behind, causing the child's arms to be pulled backwards, causing injury. This incident was not reported to the Community Care Licensing Department.

Upon conducting interviews with Staff, Children and Parents for the complaint investigation that was initiated on 03/27/24, LPA learned that T1 often yelled at children in care in an inappropriate way, which violates children's personal rights.'

The facility did an internal investigation which lead T1 to be placed on administrative leave then lead to termination on 3/22/24.

Two Title 22 deficiencies have been cited on subsequent page, LIC 809D. A Type A citation regarding personal rights and a Type B citation regarding Reporting Requirements has been cited.
An exit interview was conducted, and a Plan of Correction was reviewed and developed with the Substitute Director, Alejandra Paredes. A copy of this report and appeal rights were discussed and left with Substitute Director. A Notice of Site Visit was posted by LPA’s and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/12/2024 12:54 PM - It Cannot Be Edited


Created By: Jennie Tedlos On 06/12/2024 at 11:50 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - ELK GROVE FLORIN
FACILITY NUMBER: 343615313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/13/2024
Section Cited
CCR
101223(a)(3)

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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights:...(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature...
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SD states that after the incident, an internal investigation started. T1 was placed on administrative leave and was terminated from the facility on 3/22/24. SD also states that the facility has conducted multiple personal rights trainings, including the CCLD Personal ...
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This regulation was not met as evidenced by: LPA learned T1 forcefully pulled off a backpack from a child, causing injury. Interviews revealed that T1 would inappropriately yell at children in care. This poses an immediate health, safety, or personal rights risk to children in care.
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...Rights Training Video to staff since the incident occurredThe deficiency was cleared by today's visit and a Proof of Correction letter was provided to SD.

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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:Karyn Guerra
LICENSING EVALUATOR NAME:Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/12/2024 12:54 PM - It Cannot Be Edited


Created By: Jennie Tedlos On 06/12/2024 at 12:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: KINDERCARE LEARNING CENTER - ELK GROVE FLORIN
FACILITY NUMBER: 343615313

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2024
Section Cited
CCR
101212

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101212 Reporting Requirements (d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department ...within the Department's next working day... a written report containing the information shall be...
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SD shall submit an Unusual Incident Report to LPA about the incident that took place in 2/2024. SD will watch the CCLD Training Video on Reporting Requirements and will send a statement to LPA acknowleging their understanding on what incidents to report to CCLD.
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submitted... within 7 days...
This requirement was not met as evidenced by: LPA learned of an incident where T1 pulled a backpack off a child causing injury in 2/24 & was not reported to CCLD. This poses an potential health & safety risk to 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.
SUPERVISOR'S NAME:Karyn Guerra
LICENSING EVALUATOR NAME:Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:
DATE: 06/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/12/2024


LIC809 (FAS) - (06/04)
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