185405669-6-4-2024-13-CC-SSIS-D5WV7F-20240604161103

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 185405669
Report Date: 06/04/2024
Date Signed: 06/04/2024 04:11:08 PM

Document Has Been Signed on 06/04/2024 04:11 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 AROUND		FACILITY NUMBER:	185405669
ADMINISTRATOR:	FURTADO, LORI		FACILITY TYPE:	850
ADDRESS:	655 ASH STREET		TELEPHONE:	(530) 257-0303
CITY:	SUSANVILLE	STATE: CA	ZIP CODE:	96130
CAPACITY:	29	CENSUS: 15	DATE:	06/04/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	03:52 PM
MET WITH:	Lauri Furtado - Licensee		TIME COMPLETED:	04:20 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An unannounced case management inspection was conducted today 6/4/24 at 3:54pm by Licensing Program Analyst (LPA), Sydney Sims. LPA met with Licensee Lauri Furtado. 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 Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney Sims	TELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: 06/04/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

One Parent was interviewed on 5/24/24 and P1 stated that they do not believe the incident occurred because of a lack of supervision and that the play structure is age appropriate and that the accident could not have been prevented.

LPA Sims observed the play structure to be age appropriate.

During today’s inspection, the facility was toured and LPA Sims observed 15 children in care.

Based on interviews conducted LPA determined that no deficiencies will be cited for the incident.

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 Licensee Lauri Furtado. .

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney Sims	TELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

Page: 2 of 2