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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525404771
Report Date: 11/30/2023
Date Signed: 11/30/2023 11:08:11 AM


Document Has Been Signed on 11/30/2023 11:08 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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:BIDWELL STATE PRESCHOOLFACILITY NUMBER:
525404771
ADMINISTRATOR:BOLLINGMO, SARAHFACILITY TYPE:
850
ADDRESS:1052 DUMOSA DR.TELEPHONE:
(530) 529-5867
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:24CENSUS: DATE:
11/30/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:42 AM
MET WITH:Jamie Gordon TIME COMPLETED:
11:17 AM
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
On 11/30/2023 at 10:42 a.m. Licensing Program Analyst (LPA) J. Gifford conducted an unannounced Case Management inspection and met with Jamie Gordon. The inspection was made in response to an Unusual Incident Report (UIR) submitted by the facility on 10/9/2023. The UIR was investigated by the Department due to a possible personal rights violation on 10/2/23 involving Child 1 (C1) and Staff 1 (S1). Interviews were conducted with C1 on 10/31/23, and Staff (S1, S2) on 11/28/23. There was no evidence obtained during interviews to corroborate that the incident occurred. S1 and S2 both stated that S1 was not present during the time the incident was reported to have occurred. During the investigation, the Department also received and reviewed records. Records also indicate that S1 was not present during the time the incident was reported to have occurred. No evidence of a personal rights violation was found during the investigation. There were no Title 22 deficiencies cited during today's inspection.

An exit interview was conducted, and the report was reviewed with Jamie Gordon. A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Julie GiffordTELEPHONE: (530) 720-0207
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2023
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 1