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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 521370103
Report Date: 05/30/2024
Date Signed: 05/30/2024 11:30:04 AM


Document Has Been Signed on 05/30/2024 11:30 AM - It Cannot Be Edited

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:TEHAMA CENTERFACILITY NUMBER:
521370103
ADMINISTRATOR:GALLAGHER, RACHELFACILITY TYPE:
850
ADDRESS:650 3RD STREETTELEPHONE:
(530) 529-1500
CITY:TEHAMASTATE: CAZIP CODE:
96090
CAPACITY:44CENSUS: 13DATE:
05/30/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:56 AM
MET WITH:Rachel GallagherTIME COMPLETED:
11:40 AM
NARRATIVE
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An unannounced case management inspection was conducted today at 8:56 am by Licensing Program Analyst (LPA), Bianca Mendez and Kayla Danielson. LPA met with licensee facility representative Rachel Gallagher. In response to an Unusual Incident Report received by the Department on 5/21/24. Child (C1) was left outside on the playground for an estimated time of 5 minutes while children transitioned from outside to inside.

Facility representative was interviewed on 5/30/24 at 9:01am and stated that on 5/21/24 they were outside and counted the children when they were coming inside and they were responsible for counting and had counted the wrong number of children and the incident happened at 11:25am as they came inside to wash hands, transition to music and then lunch. At 11:28am children were transitioning to lunch and sat down at the lunch table with their assigned name card and then realized (C1) was outside and sent a teacher to get C1. C1 had came inside the building on their own and S2 had met with C1 at the door.

Parent (P1) was interviewed on 5/29/24 at 10:50am and stated that C1 is doing okay and did cry when the incident happened. P1 stated that they were informed right away when the incident had occurred and received a call from facility representative. P1 stated that staff had miscounted and they did count but must have been off. P1 does not believe it happens often.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2024
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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Document Has Been Signed on 05/30/2024 11:30 AM - It Cannot Be Edited

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: TEHAMA CENTER
FACILITY NUMBER: 521370103

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/30/2024
Section Cited
CCR
101229(a)(1)

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(a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Will have 2 staff conducting headcounts while children are outside and have children sit at the bench and conducting second counts. Staff will conduct physical sweeps of the playground and submit a a plan to LPA of recent changes.
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This was not met as evidence by: based on interviews and record review, C1 was unsupervised for 5 minutes on the playground while class was transitioning from outside. This poses an immediate health, safety, or personal rights risk to persons in care.
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All parents should have a signed LIC 9224 in children's file for new and currently enrolled children.
Plan of action to be submitted to CCL by 5/31/24

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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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:
DATE: 05/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/30/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4


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: TEHAMA CENTER
FACILITY NUMBER: 521370103
VISIT DATE: 05/30/2024
NARRATIVE
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Staff (S1-S3) were interviewed on 5/30/24. S1 stated they were not present during the incident.S1 stated they had returned from lunch at 11:25am and was not present outside on the playground. S1 stated they were on their lunch break when children were outside and children come in at 11:20am and when children were done washing their hands they go into the classroom with a teacher for music. S1 stated there is usually 2 staff assisting with handwashing. S1 stated that S2 noticed that C1 was missing from their table during lunch time. S1 stated that C1 was missing for not even 5 minutes. S2 stated that they were not outside when children were outside. S2 stated that they noticed at their table during lunch that C1 was not there. S2 stated that all children have a name tag at their table and asked staff if C1 had went home and scanned the classroom and did not see C1 there. S2 was going to head outside and then C1 had opened the door and walked into the building. S3 stated that they came inside the building with another child, they are usually are the first ones to come inside and wash their hands. S3 stated that they had heard that C1 was outside for 4 to 5 minutes. 3 of 3 staff stated they are doing headcounts for children when they transition from outside to inside.

Child (C1) was interviewed on 5/30/24 and stated that they were outside at the sandbox and saw that there was no teacher outside and then came inside the building by their self.
C1 stated that none of the teachers had opened the door for them.


During today’s inspection, the facility was toured. LPA observed a total of 4 staff and 13 children present. LPA obtained photos of the playground and gates were securely latched.


Based on information reported and interview conducted the following deficiency is being cited on the LIC809-D due to a lack of supervision
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: TEHAMA CENTER
FACILITY NUMBER: 521370103
VISIT DATE: 05/30/2024
NARRATIVE
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LPA Bianca Mendez informed facility representative Rachel Gallagher that this report dated 5/30/24 documents 1 Type A citation(s) which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

LPA Bianca Mendez informed the facility representative to provide a copy of this licensing report dated 5/30/24 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.



Exit interview conducted and report was reviewed with the facility representative Rachel Gallagher. Appeal Rights were provided.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4