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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045406198
Report Date: 01/23/2025
Date Signed: 01/23/2025 02:49:49 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/04/2024 and conducted by Evaluator Tammy Dutra
COMPLAINT CONTROL NUMBER: 13-CC-20241104092348
FACILITY NAME:KIDSPARKFACILITY NUMBER:
045406198
ADMINISTRATOR:KAWAOKA D./STRONG L.FACILITY TYPE:
840
ADDRESS:2477 FOREST AVE., STE. 190TELEPHONE:
(530) 895-6800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:20CENSUS: 10DATE:
01/23/2025
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Rubimaria BeckTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Failure to report injury of daycare child
INVESTIGATION FINDINGS:
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On 1/23/25 at 2:25pm, Licensing Program Analyst (LPA) Tammy Dutra and Bianca Mendez conducted an unannounced complaint inspection and met with facility representative Rubimaria Beck. It was alleged that the facility failed to report injury of daycare child.

The licensee was interviewed on 11/13/24 at 4:26pm and stated she was informed there was a child (C1) who sustained an injury in care. Licensee shared that based on the behavior of the child, staff determined the injury was minor and did not inform the parent of the incident until the end of the day. Licensee stated she did not believe it was important to report the incident to Community Care Licensing because the injury appeared to be minor. Licensee was informed on 11/4/24 that C1 was taken to a physician and referred to an orthopedic physician following the visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 13-CC-20241104092348
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KIDSPARK
FACILITY NUMBER: 045406198
VISIT DATE: 01/23/2025
NARRATIVE
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Three staff were interviewed on 1/17/25. All staff indicated that C1 did not appear to have a serious injury and they did not immediately report the incident to the parent or fill out an unusual incident report. None of the staff called to report the incident to Community Care Licensing on the following business day, nor were any documents received regarding the incident.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), CCR 101212(d)(1)(C) is being cited on the attached LIC 9099D.

During today’s inspection, the facility was toured, and LPA observed 3 staff and 10 children present. Facility was operating within licensing capacity and ratio requirements. No Title 22 violations were observed on today’s visit.


Exit interview conducted and report was reviewed with the facility representative Rubimaria Beck. Appeal rights were provided.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20241104092348
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDSPARK
FACILITY NUMBER: 045406198
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/23/2025
Section Cited
CCR
101212(D)(1)
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A report shall be made to the Department by telephone or fax within the Department's next working day... a written report... shall be submitted to the Department within seven days... (1) Events reported shall include the following: (B) Any injury to any child that requires medical treatment. This regulation was not met as evidence by:
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Licensee shall hold individual staff meetings to review licensing reporting requirements. Licensee will have staff sign a statement confirming they have watched the video and understand licensing reporting requirements.
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Based on observation and record review, the licensee did not comply with the section cited above C1 sustained an injury requiring medical treatment which was not reported to CCL which poses an immediate health, safety, or personal rights risk to children in care.
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Meeting agenda including viewing Child Care reporting requirements Child Care Reporting Requirements –Video– Resources for Parents and Providers and staff attendance shall be submitted to CCL by 2/3/25.
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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.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3