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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407504
Report Date: 04/19/2021
Date Signed: 04/19/2021 04:12:24 PM

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:CHICO CHILD DEVELOPMENT CENTER - PRESCHOOLFACILITY NUMBER:
045407504
ADMINISTRATOR:CAPERELLO, SHELLYFACILITY TYPE:
850
ADDRESS:850 PALMETTO AVENUETELEPHONE:
(530) 894-1778
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY:35CENSUS: DATE:
04/19/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Shelly CaperelloTIME COMPLETED:
11:00 AM
NARRATIVE
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A visit was conducted in response to an unusual incident that was self-reported in a timely manner by Shelly Caperello, the facility licensee/director. The incident occurred on 3/30/21 at about 11:42am. Community Care Licensing (CCL) was notified within 24 hours and it was sent in writing within 7 days as required. Licensee reported that a child (C1) had gone through a gate in the playground and made it to Palmetto avenue before being stopped by a Parent (P1).
LPA conducted interviews with staff, parents and witnesses and it was corroborated that (C1) was not under constant supervision during the incident. Staff #1 (S1) was in the play yard with approximately 6 children; (S1) was assisting children who were fighting over a swing when she observed (C1) right after he left the play yard. (S1) immediately used the walke talkie to call for another staff (S2) to assist because she could not leave the rest of the children. (S2) responded right away but was not immediately sure which way (C1) had gone. (S2) located the daycare child at Palmetto Ave, being loaded into (P1) one of the parent’s vehicles; (C1) was driven back to the facility and appeared unharmed. It is unclear how long the child was unsupervised; C1 was described as traveling quickly quickly, by foot, and made it at least to the end of the block on Palmetto Avenue where there was traffic.

Lack of supervision resulting in a child wandering away from the childcare. The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 9099D. 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. Notice of Site Visit shall be posted for 30 days from today’s visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2021
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: CHICO CHILD DEVELOPMENT CENTER - PRESCHOOL
FACILITY NUMBER: 045407504
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/20/2021
Section Cited

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Absence of Supervision 1596.99(c)(3) The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: Absence of supervision, including, but not limited to, a child left unattended, and supervision of a child by a person under 18 years of age.
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This requirement was not met as evidenced by interviews the child was unsupervised on 3/30/21.
An immediate civil penalty of $500 applies. This poses an immediate heath and safety risk to children in care.
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Recommended resource for Active Supervision training: https://eclkc.ohs.acf.hhs.gov/safety-practices/article/keep-children-safe-using-active-supervision

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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: Erin VirruetaTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2021
LIC809 (FAS) - (06/04)
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