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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364804213
Report Date: 07/26/2022
Date Signed: 07/28/2022 03:56:29 PM

Substantiated


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
04/19/2022 and conducted by Evaluator Aman Sharma
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220419115408
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804213
ADMINISTRATOR:MELINDA GASKINFACILITY TYPE:
830
ADDRESS:2140 S. EUCLIDTELEPHONE:
(909) 983-5007
CITY:ONTARIOSTATE: CAZIP CODE:
91762
CAPACITY:28CENSUS: 6DATE:
07/26/2022
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Jennifer DelunaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not feed day care child
INVESTIGATION FINDINGS:
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On this date and time, Licensing Program Analysts (LPAs) Aman Sharma and Rachel Zeron arrived at the facility to deliver the findings of this complaint investigation which was initiated on 04/27/2022. LPAs met with acting assistant director, Jennifer Deluna and explained the purpose of today’s visit was to conclude the complaint investigation. LPAs toured the facility, took census, and discussed the following with the acting director:

During the investigation, LPAs Sharma and Mejorado made observations, reviewed documentation (bottle feeding log) and conducted interviews with pertinent parties. It was alleged, staff did not feed a day care child on or about 04/12/2022 due to the child’s formula accidentally being partially given to another infant.

PLEASE SEE LIC9099C..................

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022
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-20220419115408
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: 364804213
VISIT DATE: 07/26/2022
NARRATIVE
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LPAs investigated the allegation and gathered the following information:

It was reported, staff did not feed day care child. During the investigation, facility staff admitted to LPAs that one infant had been fed another infant’s bottle. LPAs reviewed a “bottle feeding log” kept in the facility to keep track of times infants have been fed. LPAs noticed on or around the date of the incident, a child was not fed for more than four hours. This was due to staff mixing up two infants’ bottles. Based on LPA interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC9099D.

An exit interview was conducted with the acting assistant director, Appeal Rights were discussed and issued, a copy of this report was provided, and a Notice of Site visit was issued. Upon receipt of this report, the acting director/acting assistant director shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Acting assistant director was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224).

A copy of this report must be made available upon request for the next three years.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 09-CC-20220419115408
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: 364804213
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2022
Section Cited
CCR
101427(c)(1)
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Food Service:
The infant shall be fed in accordance with the individual plan. (1) Bottle-fed infants shall be fed at least once every four hours.
This requirement was not met as evidenced by:
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Acting assistant Director stated she will have a staff meeting to retrain staff on bottle feeding. Director will send in proof of training and a list of participants. Director will also implement a plan going forward to better assess feeding to ensure children are fed at least once every four hours. Director agreed to send plan to CCL by COB on POC date.
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Based on staff admission, bottle feeding logs showing child was not fed for more than four hours at a time, and incidnet report. This poses an immediate risk to the health and safety of children in care. Plan of correction discussed with acting assistant director.
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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: Kimberly Williams
LICENSING EVALUATOR NAME: Aman Sharma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3