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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 045407504
Report Date: 07/23/2024
Date Signed: 07/23/2024 04:37:02 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 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
07/22/2024 and conducted by Evaluator Erica Laird
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20240722163445
FACILITY NAME:CHICO CHILD DEVELOPMENT CENTER - PRESCHOOLFACILITY NUMBER:
045407504
ADMINISTRATOR:MORALES, VALERIA DOMINGUEZFACILITY TYPE:
850
ADDRESS:850 PALMETTO AVENUETELEPHONE:
(530) 894-1778
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY:35CENSUS: 22DATE:
07/23/2024
UNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Shelly Caperello, OwnerTIME COMPLETED:
04:49 PM
ALLEGATION(S):
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Failure to report injury of daycare child
INVESTIGATION FINDINGS:
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On 7/23/24 at 2:40pm, Licensing Program Analyst (LPA) Erica Laird conducted an unannounced complaint inspection, and met with facility owner, Shelly Caperello. It was alleged that staff failed to report and injury of a daycare child, specifically that a child (C1) sustained an injury which required medical attention and the facility did not report the incident to licensing.

Facility owner Shelly Caperello was interviewed on 7/23/24 at 3:01pm and admitted to knowledge of the allegation, and stated that there was an incident when C1 was injured at school and was taken to the ER. Shelly stated she doesn't know why they didn't call licensing, it must have been an oversight.

On 7/23/24 LPA Laird interviewed three staff (S1, S2, S3). All staff interviewed stated they knew of an incident involving C1 getting injured at the facility. S2 and S3 stated they were present when the incident occurred and knew C1 had gone to the hospital where they received treatment. S2 stated they didn't think to inform licensing about the incident. Report continued on 9099C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
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-20240722163445
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: CHICO CHILD DEVELOPMENT CENTER - PRESCHOOL
FACILITY NUMBER: 045407504
VISIT DATE: 07/23/2024
NARRATIVE
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On 7/23/24 LPA Laird conducted one staff record review and one child record review and obtained medical records and communication records.

Based on documentation and interviews, 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.

Exit interview conducted and report was reviewed with facility owner, Shelly Caperello. 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: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20240722163445
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CHICO CHILD DEVELOPMENT CENTER - PRESCHOOL
FACILITY NUMBER: 045407504
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/22/2024
Section Cited
CCR
101212(d)(1)(C)
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101212; (d) (1)...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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 Facility shall hold an all-staff meeting to review licening reporting requirements. Meeting agenda and staff attendance sheet shall be submitted to CCL by 8/23/24.

erica.laird@dss.ca.gov
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Based on observation and record review, the licensee did not comply with the section cited above for 1 out of 5 staff members (S1), which poses an immediate health, safety, or personal rights risk to children in care.
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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: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3