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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455401406
Report Date: 09/26/2019
Date Signed: 09/26/2019 03:41:58 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:WEST REDDING PRESCHOOLFACILITY NUMBER:
455401406
ADMINISTRATOR:WOOD, VICTORIAFACILITY TYPE:
830
ADDRESS:3490 PLACER ROADTELEPHONE:
(530) 243-2225
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY:37CENSUS: 19DATE:
09/26/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Tammy HovisTIME COMPLETED:
03:15 PM
NARRATIVE
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A case management inspection was conducted at the facility by Licensing Program Analysts (LPAs) Emilia Grisak and Patricia Pacheco. During previous investigation, it was revealed that on 08/22/19, Child 1 (C1) tripped while walking through a gated in the infant room and fell hitting their face on the floor. It was reported that the child chipped their tooth and required medical attention. LPAs reviewed the incident with the licensee and staff. Per interviews, it was corroborated that the child tripped while walking through the gated divider in the infant room and the incident was witnessed by two staff who were unable to catch C1 in time. The child's authorized representatives were contacted immediately and an ouch report was provided to them. This unusual incident report was not reported to the Department as required. This report was reviewed and discussed with the director. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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: WEST REDDING PRESCHOOL
FACILITY NUMBER: 455401406
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/04/2019
Section Cited

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Reporting Requirements. Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the
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information specified in (d)(2) below shall be submitted to the Department within seven days following the occurrence of such event. This requirement was not met as evidenced by: based on file reviews, the licensee failed to report that C1 sustained an injury whle in care that required medical attention. This poses a potential health and safety risk for 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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2019
LIC809 (FAS) - (06/04)
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