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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364807781
Report Date: 11/23/2021
Date Signed: 11/23/2021 06:33:13 PM

Document Has Been Signed on 11/23/2021 06:33 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
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364807781
ADMINISTRATOR:DIEHL, JENNIFERFACILITY TYPE:
840
ADDRESS:15928 LOS SERRANOS COUNTRY CLBTELEPHONE:
(909) 606-7744
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY: 52TOTAL ENROLLED CHILDREN: 32CENSUS: 20DATE:
11/23/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:57 PM
MET WITH:Jennifer DiehlTIME COMPLETED:
03:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kim Leung returned to the facility this date on 11/23/2021 to continue gathering information regarding the Unusual Incident Report (UIR) received from the facility on 10/19/2021. The UIR documented that the facility received report alleging Staff 1 moved a mask over Child 1's nose and then pinched the child's nose. Records were reviewed and interview was conducted during the previous inspection on 10/22/2021.

After the previous inspection, LPA was able to gather additional information. During this inspection, LPA conducted additional interview. LPA obtained information that when Child 1, who was able to put on a mask properly without assistance, was wearing a mask in the manner that the mask was not covering the mouth and the nose, Staff 1 redirected the child verbally and then went up to the child pulling the mask over the child's nose without the child's consent. LPA obtained information that Staff 1 also tightened the mask for child 1 by pressing the nose bridge strip of the mask without the child's consent. Per the current COVID-19 Child Care Guidance for Child Care Providers and Programs, children, 2 years of age and older, are encouraged to wear face coverings while attending child care facilities. However, the manner the staff member redirected the child to properly wear face covering violated the child's personal rights.

See LIC809D for deficiency cited.

Exit interview was conducted with director Jennifer Diehl. Appeal rights were explained. Notice of Site Visit was issued and it must be posted up at the front office for 30 days. A copy of this report was provided to the director.
This report must be made available at the facility for 3 years for public review upon request.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Kim Leung
LICENSING EVALUATOR SIGNATURE: DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/23/2021
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 11/23/2021 06:33 PM - It Cannot Be Edited


Created By: Kim Leung On 11/23/2021 at 01:31 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 364807781

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/23/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/24/2021
Section Cited
CCR
101223(a)(3)

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Personal Rights. To be free from corporal or unusual punishment, infliction of pain, humiliation, The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation... This requirement was not met as evidenced by: When a child's face
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The staff member is no longer working for the facility after 10/26/2021. Director Jennifer Diehl agreed to provide training to staff on the dos and don'ts regarding face covering guidance. Proof of training with staff signature will be submitted to the Department by 11/24/2021.
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covering was not covering the mouth and the nose, Staff 1 went up to the child pulling the mask over the child's nose and pressed the nose bridge strip to tighten the mask without the child's consent. That violated the child's personal rights especially with the knowledge that the child was capable to wear mask properly without assistance..
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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:Aaron Ross
LICENSING EVALUATOR NAME:Kim Leung
LICENSING EVALUATOR SIGNATURE:
DATE: 11/23/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/23/2021


LIC809 (FAS) - (06/04)
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