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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483001829
Report Date: 09/04/2024
Date Signed: 09/04/2024 04:28:54 PM

Document Has Been Signed on 09/04/2024 04:28 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
483001829
ADMINISTRATOR/
DIRECTOR:		HAYMER, MORNENFACILITY TYPE:
840
ADDRESS:581 PEABODY ROADTELEPHONE:
(707) 447-7685
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 24TOTAL ENROLLED CHILDREN: 32CENSUS: 5DATE:
09/04/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Brenda Hardaway - Center DirectorTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
NARRATIVE
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Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced Case Management (CM) visit and met with Center Director (CD), Brenda Hardaway, to deliver a citation related to violation of a child’s (C1) personal rights. On 04/09/24, the facility submitted an Unusual Incident Report (LIC 624) to self-report an incident which involved a staff (S1) allegedly picking up and throwing C1 to the floor while they were in the class. It is noted that the facility did not notify the Department of the incident by telephone or fax within the Department’s next working day. LPA made a prior visit to the facility on 04/11/24 to investigate the circumstances surrounding the incident, and at that time, LPA interviewed CD and five staff (S1-S5). The children were unavailable on 04/11/24, however; four children (C1-C4) were interviewed on 07/03/24.

CD’s statement supported claims related to S1 violating C1’s personal rights and CD stated that more than one witness in the classroom observed the incident. According to CD, witnesses described C1 was standing, and then S1 asked children in the classroom to sit down to do their homework, C1 verbally responded to S1 which resulted in S1 approaching and picking C1 up with her hands; and threw or pushed C1 to sit on the floor. CD confirmed the facility conducted its own internal investigation and the outcome resulted in S1 no longer employed at the facility. S1 denied claims about putting her hands on C1 and said she did not touch C1, while S2-S5 reported they were not present and they did not witness the incident; S5 did however claim that the children in the class told her about the incident. Interviews with C1-C3 corroborated the children either experienced or witnessed the incident. The children’s statements were consistent with each other, validated S1 was upset & put her hands on C1; and engaged in misconduct. Children reported S1 responded to C1 in an aggressive manner, and words such as threw, pushed, or dropped were used to described how C1 went from a standing to sitting position. (Continue to LIC 809-C)

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001829
VISIT DATE: 09/04/2024
NARRATIVE
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Based on interviews conducted with involved parties, there is enough preponderance of evidence to support claims related to S1 violating C1’s personal rights. Exit interview conducted and report was reviewed with the Center Director, Brenda Hardaway. Notice of Site Visit shall be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The following Title 22 Deficiencies were observed and cited during today’s inspection. Appeal Rights were provided.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/04/2024 04:28 PM - It Cannot Be Edited


Created By: Melchisedeck Augustin On 09/04/2024 at 02:47 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: KINDERCARE LEARNING CENTER
FACILITY NUMBER: 483001829

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2024
Section Cited
CCR
101223(a)(3)

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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, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or
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Director said S1 was no longer employed at the facility and Director intends to hold all staff meeting to provide additional training on personal rights. Director intends to submit evidence of staff attendance at the training, agenda, video trainings from CCLD website, and written/plan statement indicating expectations
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withholding of shelter, clothing, medication or aids to physical functioning.
This requirement was not met as evidenced by: Based on statements provided by CD & C1-C3 which confirmed S1 threw or pushed C1 to a sitting position. This posed a potential health, safety and/or personal rights risk to children in care.
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and requirements of personal rights.

Email: [email protected]
Fax: 707-588-5099
Type B
09/11/2024
Section Cited
CCR101212(d)

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Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)(2) below shall be submitted to
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Director stated she would review the regulations on reporting requirements and Director intends to produce a written statement detailing how the facility would comply with CCR 101212(d).
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the Department within seven days following the occurrence of such event.
This requirement was not met as evidenced by: Based on the facility not notifying the department of an unusual incident in a timely manner. This posed a potential health, safety and/or personal rights risk to children in care.
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Email: [email protected]
Fax: 707-588-5099
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:Leslie Lepori
LICENSING EVALUATOR NAME:Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:
DATE: 09/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/04/2024


LIC809 (FAS) - (06/04)
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