493007238-9-3-2019-01-CC-ASTR-BFNQUJ-20190903122850

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493007238
Report Date: 09/03/2019
Date Signed: 09/03/2019 12:28:56 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME:	CHADWICK, DEBRA FCCH		FACILITY NUMBER:	493007238
ADMINISTRATOR:	CHADWICK, DEBRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 544-7244
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95401
CAPACITY:	14	CENSUS: 7	DATE:	09/03/2019
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Debra Chadwick		TIME COMPLETED:	12:45 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	A case management inspection was made to the facility by Licensing Program Analyst (LPA) Amy Strother in response to an Unusual Incident Report (UIR) received on 08/16/2019. Licensee, Debra Chadwick reported that at 11:50 a.m. on 08/14/2019, Child 1 (C1, age 9 months) was sitting on the floor near the coffee table, while Child 2 (C2) was across the room in the brown recliner chair, when Assistant, Staff 1 (S1) walked to the back door to check the diapers of other children present. Licensee stated that S1 was about 4 feet away from C2 when she heard a shriek from C1. The licensee turned around to see C2’s right hand clawing at C1’s face and her mouth close to C1’s right cheek. Upon inspection, licensee noted that C1 had multiple scratch marks and bite marks on her face, breaking the skin. S1 took C1 to the kitchen to clean the bite, a wet towel and coconut oil were applied. Parents of C1 were notified at 1:45 p.m.; C2's parents were notified at 12:00 p.m. and were required to pick up C1. Licensee stated during today's inspection that C1's parents took her to see a doctor 1 week after the incident, because they had an appointment already scheduled. Both C1 and C2 are still currently enrolled in care. This incident was reported to Community Care Licensing as required. Based on information available at this time, it does not appear that the incident resulted due to a lack of supervision or any other deficiency of Title 22 regulations. During today's inspection the Licensee stated that C2 has never bitten another child while in care before this incident and it has not happened again. Licensee immediately developed an action plan and covered the plan with the assistants, Staff 1 and Staff 2 (S1 & S2). The plan includes the following for C2: reinforce positive behavior, give firm time outs when needed, praise good manners, make time to interact and play with C2 one on one. Licensee stated that all staff have been shadowing C2 and stay within arms length of C2, who has not bitten any children since the incident on 08/14/19. LPA gave an NAEYC article titled, "Understanding and Responding to Children Who Bite" to the Licensee to review, share with staff and parents as a resource if desired. Continued on LIC 809-C.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: CHADWICK, DEBRA FCCH	FACILITY NUMBER: 493007238
	VISIT DATE: 09/03/2019

NARRATIVE

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During today's inspection, staff were observed to provide adequate supervision and operate within ratio, with 7 children receiving supervision from three staff.

This report was reviewed and discussed with the Licensee. All licensing reports are public information and must be made available upon request.

No deficiencies were cited during this inspection.

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

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019

LIC809 (FAS) - (06/04)

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