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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 041374498
Report Date: 08/10/2022
Date Signed: 08/10/2022 10:36:52 AM


Document Has Been Signed on 08/10/2022 10:36 AM - 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:STORYBOOK SCHOOLHOUSEFACILITY NUMBER:
041374498
ADMINISTRATOR:VINSONHALER, DENIFACILITY TYPE:
840
ADDRESS:794 E. 3RD AVENUETELEPHONE:
(530) 895-8793
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY:51CENSUS: 24DATE:
08/10/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Heather MillerTIME COMPLETED:
10:45 AM
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A Case Management visit was conducted by Licensing Program Analyst, Wisehart who met with Heather Miller to discuss reporting requirements and the commingling of age groups across licensees.

Upon LPA arrival to the site at 9:15 am the LPA observed the Director, Heather Miller with the school aged children using the outdoor play area. The Director was alone with 24 children, saying that she had an aide who was using a restroom. The Director was over ratio for a few minutes before the aide enjoyed the group.

On 6/21/22 an incident occurred resulting in C1 fracturing an arm. The child was taken to the hospital on 6/22/22 however, the facility did not submit an incident report until 7/18/22 which is outside the 7-day required time frame.

Interviews with 3 out of 3 witnesses indicate that children from different license age groups are commingled often in the morning. Interviews with 1 out of 1 child, indicated children from different license age groups are commingled at the end of the day when staff take the children to the front building. Interviews with 2 out of 2 staff indicated that commingling happens for a short period of time at the start or end of the day when only a few children are present.


Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
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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Document Has Been Signed on 08/25/2022 03:57 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/25/2022 11:04 AM

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: STORYBOOK SCHOOLHOUSE
FACILITY NUMBER: 041374498

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/11/2022
Section Cited

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Limitations on Capacity 101161(a) A licensee shall not operate a childcare center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by: Based on interviews children from different licensed age groups are commingled at the beginning and end of the day. This poses an immediate health, safety or personal rights risk to persons in care.
Type B
08/24/2022
Section Cited

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Reporting Requirements 101212 (d)(1)(B) Upon the occurrence, during the operation of the childcare 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 the Department within seven days following the occurrence of such event.
(1 ) Events reported shall include the following: (B) Any injury to any child that requires medical treatment.
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This requirement was not met as evidenced by: Based on interview and record review C1 had a medical visit but the report was not sent to CCL within the 7-day required time frame. This poses a potential health, safety or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/10/2022 10:36 AM - It Cannot Be Edited

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: STORYBOOK SCHOOLHOUSE
FACILITY NUMBER: 041374498

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/11/2022
Section Cited

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Teacher-Child Ratio 101216.3 There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance
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This requirement was not met as evidenced by: Based on observation, the Director was supervising 24 children on the playground at 9:15 when LPA arrived.

This poses an immediate health, safety or personal rights risk to persons in care.


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training and topic's covered by 8/11/22.

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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.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
LIC809 (FAS) - (06/04)
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