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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364809075
Report Date: 09/12/2022
Date Signed: 09/12/2022 03:36:46 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
08/04/2022 and conducted by Evaluator Justin Giese
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220804103255
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364809075
ADMINISTRATOR:ALISA HOLTEGARRDFACILITY TYPE:
850
ADDRESS:960 W. BLOOMINGTONTELEPHONE:
(909) 877-3399
CITY:BLOOMINGTONSTATE: CAZIP CODE:
92316
CAPACITY:104CENSUS: 33DATE:
09/12/2022
UNANNOUNCEDTIME BEGAN:
02:33 PM
MET WITH:Alisa HoltegarrdTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not prevent a daycare child from repeatedly harming another daycare child
INVESTIGATION FINDINGS:
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On 09/12/22 at time listed above Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA met with Facility Director, Alisa Holtegarrd regarding the above allegation, which were received on 08/04/2022.

The following was alleged: Staff did not prevent a daycare child from repeatedly harming another daycare child

It was alleged, on 08/04/2022, a child in care was struck multiple times and kicked by another child and as a result, the child sustained a fractured ankle. On 08/05/2022 LPA made an unannounced visit to the facility. LPA reviewed records/documents and interviewed the facility Director and pertinent staff involved. On 08/18/2022 and 08/22/2022, LPA conducted additional visits for further investigation
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
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 6
Control Number 09-CC-20220804103255
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: 364809075
VISIT DATE: 09/12/2022
NARRATIVE
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There were three staff present and statements from staff corroborate the incident occurred. One staff was changing a child’s diaper, another staff was returning from break, and another staff was exiting the classroom. One staff stated, as they were exiting the classroom, they heard a “smack” noise from across the room. Staff stated they turned around, intervened, and separated a child from hitting another child. Another staff stated a child was continuously fanning/swing their arms at another child, striking a child in the face. Staff stated in addition to striking the child in face, the child unintentionally kicked the other child while staff intervened.

On 08/05/2022, LPA was provided with an Incident/Accident Report for Parent/Guardian. This document, which was provided to the injured Child’s Parent/Guardian from the facility, stated, “While sitting for circle time another child continuously smacked… then moved onto kicking… once in the leg.”



On 08/22/2022, the Director provided the LPA with medical documentation for the injured child which confirmed the child sustained an ankle fracture.

Based on LPAs observations, interviews conducted, and records reviewed/obtained, the preponderance of evidence standard has been met, therefore the above allegations, staff did not prevent a day care child from repeatedly harming another day care child, are found to be SUBSTANTIATED. Please see attached LIC9099D for Type A deficiency cited.

A Civil Penalty of $500 will be assessed during this investigation for a violation of Responsibility for Providing Care and Supervision. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”.

YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 09-CC-20220804103255
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: 364809075
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/12/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/13/2022
Section Cited
CCR
101221(a)(1)
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Supervision (a) No child(ren) shall be left without the supervision of a teacher at any time... (1) Supervision shall include visual observation.

This requirement has not been met as evidenced by:
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IMMEDIATE CIVIL PENALTY OF $500 WILL BE ASSESSED
Facility Director understands the importance of providing care and supervision for children in care at all time. Facility director will conduct a training session with staff and submit the outline of topics discussed regarding maintaining
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Based on Interviews and records reviewed, on 08/04/22 Staff were transitioning between scheduled breaks, in this timeframe a child was struck multiple times and kicked by another child and as a result, sustained a fractured ankle before staff intervention. This poses an immediate health and safety risk to the children in care.
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visual supervision and transitioning between scheduled breaks. Documentation of training/proof of correction will need to be submitted to LPA on or before the date of correction, 09/13/2022.
Office meeting with CCL Management will be scheduled at a later date.
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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: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
08/04/2022 and conducted by Evaluator Justin Giese
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20220804103255

FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364809075
ADMINISTRATOR:ALISA HOLTEGARRDFACILITY TYPE:
850
ADDRESS:960 W. BLOOMINGTONTELEPHONE:
(909) 877-3399
CITY:BLOOMINGTONSTATE: CAZIP CODE:
92316
CAPACITY:104CENSUS: 33DATE:
09/12/2022
UNANNOUNCEDTIME BEGAN:
02:33 PM
MET WITH:Alisa HoltegarrdTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not provide a daycare child first aid
INVESTIGATION FINDINGS:
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On 09/12/22 at time listed above Licensing Program Analyst (LPA) Justin Giese made an unannounced visit to the facility for the purpose of concluding a complaint investigation. LPA met with Facility Director, Alisa Holtegarrd regarding the above allegation, which were received on 08/04/2022.

The following was alleged: Staff did not provide a daycare child first aide
It was alleged, on 08/04/2022, a child in care was struck multiple times and kicked by another child and as a result, the child sustained a fractured ankle.

LPA made initial contact with the facility on 08/05/2022 and made subsequent visits on 08/18/2022 and 08/22/2022 for further investigation. As part of the investigation LPA interviewed the facility Director and pertinent parties involved. Due to the time of incident occurrence and the time the child involved was released to their parent/guardian LPA was unable to determine if staff had adequate time to fully assess the extent of the child’s injuries or render first aide.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 09-CC-20220804103255
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: 364809075
VISIT DATE: 09/12/2022
NARRATIVE
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Therefore, due to conflicting information found throughout this investigation this agency has investigated the complaint alleging: Staff did not provide a day care child first aide. 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 the allegation is UNSUBSTANTIATED.

A NOTICE OF SITE VISIT WAS GIVEN. DIRECTOR WAS INSTRUCTED TO POSTED IT IN A PROMINENT LOCATION AT THE FACILITY. THE DIRECTOR UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

An exit interview was conducted, A copy of this report and appeal rights were given to the Director during this inspection on 09/12/2022.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 09-CC-20220804103255
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: 364809075
VISIT DATE: 09/12/2022
NARRATIVE
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An exit interview was conducted, A copy of this report and appeal rights were given to the Director during this inspection on 09/12/2022.

LPA issued a Notice of Site Visit and verified it was posted in a prominent location at the facility. Director understands that the Notice of Site Visit must remain posted for the next 30 days along with a copy of all Type A deficiencies cited during this inspection. A copy of all Type A deficiencies cited during this inspection must also be immediately (within 24 hours of child’s next day in care) given to the parents of all children enrolled in the child care facility and any children enrolled into the child care facility over the next 12 months (at the time of enrollment). Licensees are required to have all parents sign and date the Acknowledgement of Receipt of Licensing Reports (LIC9224) and maintain a copy in each child’s file. A copy of this report, LIC9224 and Appeal Rights (LIC9058) were provided during this inspection.
SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
LIC9099 (FAS) - (06/04)
Page: 6 of 6