<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455403966
Report Date: 06/24/2024
Date Signed: 06/24/2024 01:40:55 PM


Document Has Been Signed on 06/24/2024 01:40 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:KINDERLAND CHILD DEVELOPMENT CENTERFACILITY NUMBER:
455403966
ADMINISTRATOR:WILSON, SUSANFACILITY TYPE:
850
ADDRESS:1630 VICTORTELEPHONE:
(530) 223-6161
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:53CENSUS: 23DATE:
06/24/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Susan Wilson - Licensee, Theresa Eisen - Assistant Director TIME COMPLETED:
01:50 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 follow up case management inspection was conducted in response to a case management inspection on 5/10/24 today at 1:00pm by Licensing Program Analyst (LPA), Sydney Sims and Tammy Dutra. LPA met with Licensee Susan Wilson . In response to an Unusual Incident Report received by the Department on 4/16/24, where a child sustained a dislocated elbow while in care.

The facility representative was interviewed on 5/10/24 at 12:48pm and stated that on 4/16/24 child C1's parents were called to pick up C1 from the facility. Licensee stated that S2 was the staff present for the incident and that S2 was holding C1's hand and C1 threw themselves backwards. S2 tried to keep C1 from hitting their head, and S1 was still holding C1's hand and then C1's elbow dislocated.

One Child (C1) was interviewed on 5/10/24 and stated that staff S2 grabbed C1's arm and bent it back hard.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney SimsTELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2024
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: KINDERLAND CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 455403966
VISIT DATE: 06/24/2024
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
Two staff were interviewed on 5/10/24, and 6/24/24 and stated that the incident that occurred was an accident and that staff S2 was trying to prevent C1 from hitting their head on the concrete.

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

Although child C1 did receive an injury while in the care of the facility it could not be determined that a personal rights violation occurred.

Exit interview conducted and report was reviewed with the Assistant Director Theresa Eisen appeal rights were provided.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sydney SimsTELEPHONE: (916) 365-5731
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2