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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045407684
Report Date: 05/16/2022
Date Signed: 05/16/2022 02:49:28 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/08/2022 and conducted by Evaluator Kirk Marks
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20220308164256
FACILITY NAME:BROWN, KIMBERLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
045407684
ADMINISTRATOR:BROWN, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 774-3368
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:14CENSUS: DATE:
05/16/2022
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Kimberly Brown, LicenseeTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff caused injury to child resulting in bruising
INVESTIGATION FINDINGS:
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On 5/16/2022 at 2:30pm Licensing Program Analyst (LPA) Kirk Marks conducted an office visit with licensee, Kimberly Brown, for the purpose of delivering complaint findings. It was alleged that a child was injured by an assistant at the facility, causing bruising on the child. LPA met with licensee on 3/16/2022 at 9:30 am and discussed the allegation. Licensee stated that the assistant has never engaged in any actions that would harm any children in care. Licensee stated not knowing of any actions by the assistant that may have been considered harmful to a child. LPA conducted an interview with the assistant on 3/16/2022. The assistant stated never doing anything that would have injured or harmed a child or doing any action that may have accidentally injured a child. LPA conducted telephone interviews with three parents of children in care (P1, P2 and P3). All three parents expressed not having any concerns about the care given by licensee or the assistant.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
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 13-CC-20220308164256
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: BROWN, KIMBERLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 045407684
VISIT DATE: 05/16/2022
NARRATIVE
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(continued from page 1)

The parents did not have knowledge of any children being harmed by the assistant or ever suspected that may have happened.
Through all interviews conducted LPA was not able to determine that the alleged incident occurred. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the allegation violation occurred, and the findings are unsubstantiated. An exit interview was conducted.
The Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2