Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 364840920
Report Date: 10/27/2017
Date Signed 10/27/2017 01:02:33 PM


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
09/22/2017 and conducted by Evaluator Fe Floria
PUBLIC
COMPLAINT CONTROL NUMBER: 09-CC-20170922144252
FACILITY NAME:KINDERCARE LEARNING CENTERFACILITY NUMBER:
364840920
ADMINISTRATOR:BIERMAN, TRACYFACILITY TYPE:
840
ADDRESS:33788 YUCAIPA BLVDTELEPHONE:
(909) 797-4713
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:36CENSUS: 11DATE:
10/27/2017
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Jenny Mc ClanahanTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Facility staff administered medication without parental permission
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Fe Floria arrived at the facility to conclude the investigation and deliver the findings on the above allegation. LPA met with Assistant Director, Jenny Mc Clanahan and discussed the findings. The facility was toured and census was taken. Initial visit was conducted on 9/27/17 and interviewed all pertinent parties and records were gathered. During the course of the investigation, it was indicated that no medication was given while the child in question was present at the Center. It was disclosed during a follow up interview that medication was given one time back in August, 2017. The Center denied the allegation and per review of medication master log, it shows no evidence that pink Tylenol was administered at the Center to the child in question.

The information obtained in the investigation did not reveal sufficient evidence to support the allegation that Facility staff administered medication without parent permission.
This report is continued on LIC9099 - C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Fe FloriaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2017
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-20170922144252
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: 364840920
VISIT DATE: 10/27/2017
NARRATIVE
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Although the allegation may have occurred or is valid, based on the information received from interviews and records reviewed, there was no preponderance of evidence to prove or disprove that the allegation occurred. Therefore, the allegation of Facility staff administered medication without parental permission is deemed Unsubstantiated at this time on this date.

An exit interview was conducted and a copy of this report was reviewed. A printed copy of appeal rights as well as the report was provided at the conclusion of this visit and their signature on this form acknowledges receipt of these rights.

The Notice of Site Visit was posted.

A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Fe FloriaTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/27/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 2