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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 085406051
Report Date: 07/22/2024
Date Signed: 07/22/2024 01:53:13 PM

Document Has Been Signed on 07/22/2024 01:53 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:LITTLE SCHOOL OF THE REDWOODSFACILITY NUMBER:
085406051
ADMINISTRATOR/
DIRECTOR:		CASTILLO, CARRIEFACILITY TYPE:
850
ADDRESS:860 SMALL AVENUETELEPHONE:
(707) 464-4174
CITY:CRESCENT CITYSTATE: CAZIP CODE:
95531
CAPACITY: 30TOTAL ENROLLED CHILDREN: 19CENSUS: 13DATE:
07/22/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Samantha SheltonTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On 07/22/24, an unannounced case management inspection was conducted today at 11 AM by Licensing Program Analyst (LPA) Kiriko Lynch. LPA met with facility representative, Acting Center Director, Samantha Shelton, in response to an Unusual Incident Report received by the Department on 07/11/24, and was self-reported to CCLD and CWS by the Licensee. It was reported that a staff (S1) held a child (C1) down on a nap mat wrapped in a blanket.

Acting Center Director was interviewed on 07/22/24, and stated that on 07/10/24 she witnessed S1 on their arms and legs holding C1 down on their nap mat using a blanket to restrain C1. She stated she immediately told S1 to stop and comforted C1 afterwards, and asked S1 to take their lunch. She stated she informed the Licensee, and S1 was put on leave pending an internal investigation and subsequent personnel action. Acting Center Director and Licensee representative were interviewed at the facility on 07/22/24, and they disclosed the details of the incident, and provided records. Five children were also interviewed at the facility on 07/22/24, and there were no disclosures of other incidents.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/22/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: LITTLE SCHOOL OF THE REDWOODS
FACILITY NUMBER: 085406051
VISIT DATE: 07/22/2024
NARRATIVE
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During the inspection visit, the facility was toured. LPA also received further information from the Licensee regarding the incident and subsequent steps they took to prevent further incidents, including their internal investigation, speaking to involved parent/guardian, and personnel action. LPA also observed appropriate care and supervision during naptime at the facility during the visit.

Based on the information reported and interviews conducted with staff, the following deficiency is being cited on the LIC 809-D.

Exit interview conducted and report was reviewed with the Acting Center Director, Samantha Shelton. Appeal Rights were provided. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/22/2024 01:53 PM - It Cannot Be Edited


Created By: Kiriko Lynch On 07/22/2024 at 01:18 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: LITTLE SCHOOL OF THE REDWOODS
FACILITY NUMBER: 085406051

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/22/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/23/2024
Section Cited
CCR
101223

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Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by a staff used an inappropriate method of discipline by
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Licensee conducted internal investigation and took personnel action by time of inspection visit, POC cleared at time of time.
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restraining a child on their nap mat.
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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:Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:
DATE: 07/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/22/2024


LIC809 (FAS) - (06/04)
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