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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045407355
Report Date: 12/17/2021
Date Signed: 12/21/2021 02:23:22 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/10/2021 and conducted by Evaluator Nicolette Cunningham
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20211210094036
FACILITY NAME:NOAH'S ARK AT CALVARY CHAPEL CHICO - PRESCHOOLFACILITY NUMBER:
045407355
ADMINISTRATOR:JACKSON, LISAFACILITY TYPE:
850
ADDRESS:1888 SPRINGFIELD DRIVETELEPHONE:
(530) 487-0776
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:30CENSUS: 20DATE:
12/17/2021
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Amy Wuestefeld, Administrative AssistantTIME COMPLETED:
10:20 AM
ALLEGATION(S):
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Facility is not following COVID-19 mask requirements for children.
INVESTIGATION FINDINGS:
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On 12/17/21 at 9:25am, Licensing Program Analysts (LPA) K. Marks and N. Cunningham conducted an unannounced complaint inspection, and met with Administrative Assistant Amy Wuestefeld. It was alleged that the facility is not following COVID-19 facial covering guidance, specifically that children in care are not wearing facial coverings.The administrative assistant was interviewed on 12/17/21 at 9:30am and stated that at this time children are not encouraged to wear facial coverings and the facility staff are discussing policies regarding facial coverings.

The LPAs toured the facility at 9:35am. The LPAs observed no signs posted and staff interacting with children without mention of facial coverings. There were a total of 10 children observed and zero of them wearing facial coverings in the Wise Whales classroom and 10 children observed and zero of them wearing facial coverings in the Gentle Giraffes classroom. The children not wearing facial coverings (C1 – C20) were playing inside their classroom.

Provider Information Notice (Pin) 21-29-CCP FACE COVERING REQUIREMENTS AND GUIDANCE FOR CHILD CARE PROVIDERS REGARDING CORONAVIRUS DISEASE 2019 (COVID-19) was discussed and a copy was provided during the inspection.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
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-20211210094036
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: NOAH'S ARK AT CALVARY CHAPEL CHICO - PRESCHOOL
FACILITY NUMBER: 045407355
VISIT DATE: 12/17/2021
NARRATIVE
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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), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20211210094036
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: NOAH'S ARK AT CALVARY CHAPEL CHICO - PRESCHOOL
FACILITY NUMBER: 045407355
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/20/2021
Section Cited
CCR
101223(a)(2)
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The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not be as evidenced by:

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The Administrative Assistant stated she will provide a copy of this report to the director and the director will e-mail a plan of correction to LPA Cunningham by 12/20/21.
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Based on observations/interviews, the director did not ensure the personal rights of children in care in that 20 of 20 children in care (C1 – C20) did not wear face coverings while in the facility, as required by the Order of the State Public Health Officer (June 11, 2021), and an individual face covering exception did not apply. This is a potential health and safety risk to children in care.
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nicolette.cunningham@dss.ca.gov
Fax: 530-895-5934
Phone: 530-521-5235
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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: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3