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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 041370378
Report Date: 08/31/2022
Date Signed: 08/31/2022 02:36:26 PM

Document Has Been Signed on 08/31/2022 02:36 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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:HELEN WILCOX PRESCHOOLFACILITY NUMBER:
041370378
ADMINISTRATOR:BUTCHER, KIMBERLYFACILITY TYPE:
850
ADDRESS:5727 AUTREY LANETELEPHONE:
(530) 533-1560
CITY:OROVILLESTATE: CAZIP CODE:
95966
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 26DATE:
08/31/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Jodie DugginsTIME COMPLETED:
03:00 PM
NARRATIVE
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On 8/31/22 at 2PM, Licensing Program Analysts (LPA) Snow & Laird conducted an unannounced case management in response to a self-report that was made in a timely manner; the incident occurred on 8/26/22 and was called in the following business day (8/29/22) and also submitted in writing on 8/29/22. The LPA’s met with site supervisor Jodie Duggins who was present at the time of incident but did not observe it. The self-report stated that according to Staff (S1) ‘the child (C1) spit at her and S1 reacted by striking C1’s face w/open palm. No physical injury or mark”. The LPA interviewed the parents of C1 and they did not confirm injury. The teacher S1 self-reported the incident and was placed on administrative leave. On 8/31/22 the LPA’s interviewed 3 staff who (have worked with S1 for 10 ,20 years and) they stated that C1 did not appear injured and S1 has never handled children roughly before this isolated incident.

Based on the self report and interviews obtained, the preponderance of evidence standard has been met, therefore a violation for personal rights was cited during today’s inspection.
The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. Notice of Site Visit shall be posted for 30 days from today’s visit.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 08/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/31/2022
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 08/31/2022 02:36 PM - It Cannot Be Edited


Created By: Jaime Snow On 08/31/2022 at 01:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: HELEN WILCOX PRESCHOOL
FACILITY NUMBER: 041370378

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/31/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/09/2022
Section Cited
CCR
101223(a)(3)

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Personal Rights The licensee shall ensure that each child is accorded the following personal rights: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule … or other actions of a punitive nature ....
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The teacher S1 self-reported the incident and was placed on administrative leave. The director has agreed to provide training to all staff pertaining to personal rights. Due on 9/9/22 an overview of the training and a list of staff who received training. Resubmit the unusual incident ....
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This requirement is not met as evidenced by: a teacher striking a child without injury, as based on self-report and interviews. Which poses an immediate Health and Safety risk to children in care.
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on the correct form (report LIC624)
Parents/guardians must sign Form LIC9224 by the next day of care. All newly enrolled must sign Form LIC9224.

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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 Virrueta
LICENSING EVALUATOR NAME:Jaime Snow
LICENSING EVALUATOR SIGNATURE:
DATE: 08/31/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/31/2022


LIC809 (FAS) - (06/04)
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