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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455407903
Report Date: 06/20/2024
Date Signed: 06/20/2024 11:19:54 AM

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
02/14/2024 and conducted by Evaluator Nicolette Cunningham
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20240214121649
FACILITY NAME:LACKEY, CHEYENNE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455407903
ADMINISTRATOR:LACKEY, CHEYENNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 768-6397
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:14CENSUS: 9DATE:
06/20/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Cheyenne Lackey, LicenseeTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Infant sustained unexplained injuires while in care
INVESTIGATION FINDINGS:
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On June 20, 2024 at 10:00am, Licensing Program Analyst (LPA) Nicolette Cunningham conducted an unannounced complaint inspection, and met with licensee Cheyenne Lackey. It was alleged that an infant (C1) sustained unexplained injuries while in care.

This complaint investigation was conducted by Community Care Licensing Division Investigative Branch (IB) Investigator, Christen Krogstad. During the course of the investigation, interviews were conducted with the licensee, three staff, four parents, six children in care and one witness.

It was alleged that C1 sustained a contusion, bruising and scrapes to their face on 2/12/24. It was also alleged that on the following day 2/13/24, C1 sustained an abrasion burn to their neck, additional bruises on their body and petechia on their shoulders. The licensee stated on 2/12/24 she observed C1 walking, unassisted on the concrete and fell face first, hitting the concrete and a hard plastic toy dinosaur. The licensee stated that she held C1 and tried to apply ice to the injury. The licensee stated she had no knowledge of any additional injuries to C1 on 2/13/24, and that she never observed the burn or mark on

Continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2024
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 4
Control Number 13-CC-20240214121649
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: LACKEY, CHEYENNE FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407903
VISIT DATE: 06/20/2024
NARRATIVE
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C1’s neck. The licensee stated that C1 had been in a bouncer chair for about 20 minutes that day. Seven photographs of C1’s injuries were obtained and show extensive bruising, marks, and scratches on C1’s body. Records from outside agencies were obtained and reviewed.

Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22, Division 12) are being cited on attached LIC 9099D.

LPA, Nicolette Cunningham informed the licensee that this report dated 6/20/24 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety or personal rights of children in care.

LPA, Nicolette Cunningham also informed the licensee to provide a copy of this licensing report dated 6/20/24 that documents a Type A citation to parents and guardians of all children enrolled by the next business day or the next day children are in care, and to any newly enrolled parents/guardians for the next 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child’s file for verification.


Continued on 9099C
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 13-CC-20240214121649
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: LACKEY, CHEYENNE FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407903
VISIT DATE: 06/20/2024
NARRATIVE
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The Department has determined that a Civil Penalty will be issued for the substantiated allegation of daycare child sustained unexplained injuries while under the care of the licensee. LPA Nicolette Cunningham reviewed the Civil Penalty Assessment – Immediate $500 and Repeat Violations (LIC421M) with the licensee. During the inspection the licensee signed the (LIC 421M).

Exit interview was conducted and report was reviewed with the licensee. A copy of this report, along with Appeal Rights (LIC 9058) were provided during today’s inspection. 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: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 13-CC-20240214121649
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: LACKEY, CHEYENNE FAMILY CHILD CARE HOME
FACILITY NUMBER: 455407903
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/21/2024
Section Cited
CCR
102417(a)
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(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times…This requirement was not met as evidenced by: Based on interviews, the licensee did not comply with the section cited above
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The licensee stated she removed the bouncer and is will no longer allow bouncers in her home. The licensee stated she is going to remove the two teeter totters and trampoline. The licensee plans on preparing a plan for the tree house.
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for one child, which poses an immediate health, safety, or personal rights risk to children in care.
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The licensee stated she will send pictures and plan to LPA Cunningham at nicolette.cunningham@dss.ca.gov.
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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: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4