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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455403185
Report Date: 12/19/2022
Date Signed: 12/19/2022 12:53:47 PM

Document Has Been Signed on 12/19/2022 12:53 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:LIONS CUB PRESCHOOLFACILITY NUMBER:
455403185
ADMINISTRATOR:ANSTINE, SHELLEYFACILITY TYPE:
850
ADDRESS:10142 OLD OREGON TRAILTELEPHONE:
(530) 223-4070
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 100TOTAL ENROLLED CHILDREN: 100CENSUS: 55DATE:
12/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Shelley Anstine TIME COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Jaime Snow conducted a case management inspection and met with Director, Shelley Anstine in response to a self reported incident. The incident was reported to Community Care licensing in a timely manner (in writing 4 days after the incident).
On 11/18/22 a child moved out of line after the head count and was left unsupervised in the bathroom for approximately 12 minutes when the class went back to the room. According to witness the child appeared unharmed and the facility is located on a secure, fully fenced school grounds.

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: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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 12/19/2022 12:53 PM - It Cannot Be Edited


Created By: Jaime Snow On 12/19/2022 at 12:47 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: LIONS CUB PRESCHOOL
FACILITY NUMBER: 455403185

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/19/2022
Section Cited
CCR
101229(a)(1)

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No child(ren) shall be left without the supervision of a teacher at any time

This requirement is not met as evidenced by the self report and interview.
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The faciltiy submitted a plan of correction
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The facility failed to adequately supervise a child in the bathroom which posed a potential Health and Safety 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.
SUPERVISOR'S NAME:Erin Virrueta
LICENSING EVALUATOR NAME:Jaime Snow
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2022


LIC809 (FAS) - (06/04)
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