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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483001827
Report Date: 08/02/2021
Date Signed: 08/02/2021 11:13:41 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/14/2021 and conducted by Evaluator Kirk Marks
COMPLAINT CONTROL NUMBER: 13-CC-20210514103440
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001827
ADMINISTRATOR:CARRERA, TONIFACILITY TYPE:
830
ADDRESS:581 PEABODY ROADTELEPHONE:
(707) 447-7685
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:20CENSUS: DATE:
08/02/2021
UNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Director, Mornen HaymerTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff restrained child in care
INVESTIGATION FINDINGS:
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On 8/02/2021 at 10:20am Licensing Program Analyst (LPA), Kirk Marks conducted a subsequent complaint investigation inspection to the facility, for the purpose of delivering complaint findings. It was alleged that a staff member (S1) restrained a child (C1) in care by pulling C1’s shirt over the back of the chair, keeping the child seated. On 5/17/2021 LPA received a photo of C1 seated in the chair with C1’s shirt pulled over the back of the chair. On 5/18/2021 LPA conducted an interview with the facility director, who stated that this did happen at the facility and she was made aware of it happening shortly after it occurred. The director stated that this was done by an individual staff member, S1, and the photo was sent to C1’s parent. The director agreed that this action was inappropriate, but it was not done to punish or harm the child. The director talked with S1 about the action and believed this action was done to keep C1 from leaving the table during meal time.

(continued on page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021
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 13-CC-20210514103440
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001827
VISIT DATE: 08/02/2021
NARRATIVE
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(continued from page 1)

On 5/24/2021 LPA conducted a telephone interview with S1 and S1 admitted to the action. S1 also stated this action was not done as punishment, but to keep the child from leaving during meal time. S1 stated being aware now that this action was not acceptable and will not engage in this action again in the future.
Based on the photo evidence and the interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22) is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview was conducted. The notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 13-CC-20210514103440
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001827
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/02/2021
Section Cited
CCR
101223(a)(3)
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Personal Rights. Each child shall be free from corporal or unusual punishment, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature.
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The Director provided training for all staff regarding definition of child restraining and positive creative supports and creating a positive classroom.
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This requirement was not met as evidenced by: based on photo evidence and interviews, staff 1 physically restrained Child 1 by pulling child’s shirt over the back of a chair while the child was seated at the chair. This is a potential health, safety, and/or personal risk to children in care.
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Documentation of training was received by LPA during inspecion, clearing the Plan of Correction.
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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: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3