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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 185405669
Report Date: 03/12/2021
Date Signed: 03/15/2021 04:28:41 PM



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
08/31/2020 and conducted by Evaluator Kirk Marks
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20200831134430
FACILITY NAME:JUST KIDDING AROUNDFACILITY NUMBER:
185405669
ADMINISTRATOR:FURTADO, LORIFACILITY TYPE:
850
ADDRESS:655 ASH STREETTELEPHONE:
(530) 257-0303
CITY:SUSANVILLESTATE: CAZIP CODE:
96130
CAPACITY:29CENSUS: DATE:
03/12/2021
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Lori FurtadoTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Day Care Center released child to unauthorized party,
INVESTIGATION FINDINGS:
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On 3/12/2021 at 11:00am Licensing Program Analyst (LPA) Kirk Marks conducted a subsequent complaint investigation inspection to the facility via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak, for the purpose of delivering complaint findings. It was alleged that a child (C1) was released to an unauthorized party without being properly identified. The facility director was interviewed on 9/15/2020 at 9:45am and stated not knowing of any time when this may have happened. Two staff members (S1 and S2) were interviewed on 2/24/2021. Neither staff member knew of any child being released without proper notification by the parent. Facility records were received by LPA on 9/21/2020 and 3/11/2020. The records indicated a signature of an individual signing out C1 on a specific date who was not authorized to pick up the child. There were no notes written stating a different person would be picking up C1 on that date.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
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 3
Control Number 13-CC-20200831134430
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: JUST KIDDING AROUND
FACILITY NUMBER: 185405669
VISIT DATE: 03/12/2021
NARRATIVE
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Based on the records received and statements from reporting party, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations (Title 22), is being cited on the attached LIC 9099D. Appeal Rights were provided and 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: 03/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20200831134430
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: JUST KIDDING AROUND
FACILITY NUMBER: 185405669
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/12/2021
Section Cited
CCR
101221(b)(5)
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Each record shall contain information including, but not limited to, the following:
Name, address and telephone number of the child's authorized representative and of relatives or others who can assume responsibility for the child if the authorized representative cannot be reached when necessary.
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Training was conducted on 9/17/2020 regarding pick up procedures. Document was received by licensing with signatures of staff confirming they received the training on 3/12/2021
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This requirement is not met as evidenced by: based on records received, C1 was signed out by person not on the child's authorized pick up list. This poses a potential health and safety risk to children 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: Kirk MarksTELEPHONE: (530) 895-5045
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3