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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 185405669
Report Date: 05/14/2024
Date Signed: 05/14/2024 03:37:30 PM


Document Has Been Signed on 05/14/2024 03:37 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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



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: 16DATE:
05/14/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:53 PM
MET WITH:Savannah Moore - Assistant Director TIME COMPLETED:
03:47 PM
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An unannounced case management inspection was conducted today at 2:53pm by Licensing Program Analyst (LPA), Sydney Sims. LPA met with facility representative Savannah Moore. In response to an Unusual Incident Report received by the Department on 5/10/24, where a child C1 was playing on a play structure and slipped resulting in two teeth needing to be removed.

The Assistant Director was interviewed on 5/14/24 at 3:02pm and stated that on 5/10/24, Child C1 was playing outside on a play structure and slipped and fell hitting their mouth on the metal Bar. Assistant Director stated that there was three staff outside at the time of the incident and that the play structure is age appropriate. Assistant Director stated that child C1 was utilizing the the equipment incorrectly but that staff was unable to redirect because C1 immediately fell upon use of the structure.

One child (C1) was interviewed on 5/14/24 and stated that C1 was climbing on the helicopter and was trying to get down and slipped. C1 stated that staff were present at the time of the incident and a staff who C1 cannot remember the name of helped C1 immediately after the incident.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney SimsTELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024
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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: JUST KIDDING AROUND
FACILITY NUMBER: 185405669
VISIT DATE: 05/14/2024
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LPA Sims observed the play structure to be age appropriate.

During today’s inspection, the facility was toured and LPA Sims observed 16 children in care.

Based on information gathered further investigation is needed.

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 Facility Representative .
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney SimsTELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
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