<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 041373685
Report Date: 10/15/2024
Date Signed: 10/15/2024 04:03:02 PM

Document Has Been Signed on 10/15/2024 04:03 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:PEANUT BUTTER PALACEFACILITY NUMBER:
041373685
ADMINISTRATOR/
DIRECTOR:		JOHNSON, PEGGYFACILITY TYPE:
850
ADDRESS:3524 HICKS LANETELEPHONE:
(530) 899-2022
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 6DATE:
10/15/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:49 PM
MET WITH:Lauren AlvaradoTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An unannounced case management inspection was conducted today at 1:49pm by Licensing Program Analyst (LPA), Bianca Mendez and Kayla Danielson. LPA met with facility representative Lauren Alvarado. In response to an Unusual Incident Report received by the Department on October 14, 2024. Facility report stated that children (C1-C3) were involved in a incident that C1 was lying down and C2 and C3 had their hands down C1's pants.

The facility representative was interviewed on 10/15/24 at 2:15pm and stated that on 10/3/24 at 10:30am they witnessed Children (C1-C3) in the outdoor play house and stated that C2 and C3 had taken turns putting their hands down C1's underwear. Facility representative stated they were outside with 7 children that day and was standing at the sandbox where they could visually see the children at the playhouse. They stated that they saw the incident and intervened but had observed C1 lying on the ground on their back. They stated they spoke with all parents regarding the incident during pick up and to prevent further incidents they blocked off the access to the children's outdoor playhouse.
LPA interviewed parents (P1-P3) on 10/9/24 and 10/10/24. 3 of 3 parents interviewed stated they were informed of the incident during pick up. 2 of 3 parents had concerns regarding supervision at the facility.
LPA attempted to interview children (C1-C2) on 10/15/24.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: PEANUT BUTTER PALACE
FACILITY NUMBER: 041373685
VISIT DATE: 10/15/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During today’s inspection, the facility was toured. LPA observed 6 children in the facility

Based on interviews it could not be determined that there was a lack of supervision for the incident to have occurred.
There were no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2