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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364804216
Report Date: 10/26/2023
Date Signed: 10/26/2023 01:56:38 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, 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
10/16/2023 and conducted by Evaluator Patricia Berry
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20231016151133
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364804216
ADMINISTRATOR:ANN-MARIE SCHOBENFACILITY TYPE:
830
ADDRESS:10191 FOOTHILL BLVD.TELEPHONE:
(909) 989-6136
CITY:RANCHO CUCAMONGASTATE: CAZIP CODE:
91730
CAPACITY:32CENSUS: 17DATE:
10/26/2023
UNANNOUNCEDTIME BEGAN:
01:11 AM
MET WITH:Dora Lopez/directorTIME COMPLETED:
02:33 PM
ALLEGATION(S):
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Staff have inadequate record keeping of the sign in and out sheet
INVESTIGATION FINDINGS:
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On 10/26/23 at 1:11 pm, Licensing Program Analyst (LPA) Patricia Berry conducted a subsequent complaint investigation. LPA met with director, toured facility and took a census.

Allegation: Staff have inadequate record keeping of the sign in and out sheet.

It was alleged the facility did not have sign in/out sheets for children. During the investigation, LPA obtained documentation and interviewed all pertinent parties, including staff.

On 10/17/23, LPA reviewed facility sign in/out sheets and Child Supervision Records (CSR's) for weeks of 9/28 to 10/16/23; however, LPA could not determine whether any sign in/out sheets were missing.

(Cont on 9099C)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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 2
Control Number 09-CC-20231016151133
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: 364804216
VISIT DATE: 10/26/2023
NARRATIVE
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Staff stated when an authorized representative enrolls a child, they don’t add sign in/out sheets to the sign in/out book until the child’s first day of attendance.

Staff stated they have never neglected adding sign in/out sheets for a child. Staff stated this procedure is explained to each authorized representative during enrollment.

Based on documents reviewed and interviews conducted, there is conflicting information from what was alleged; therefore, the above allegation is unsubstantiated.

Exit interview conducted with director report, appeal rights and notice of site visit issued.


Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Patricia Berry
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2