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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007934
Report Date: 07/26/2023
Date Signed: 07/26/2023 12:46:19 PM

Document Has Been Signed on 07/26/2023 12:46 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:KIDDIE ACADEMY - S/AFACILITY NUMBER:
483007934
ADMINISTRATOR:MCMILLEN, MELISSAFACILITY TYPE:
840
ADDRESS:880 ALAMO DRIVETELEPHONE:
7074464222
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 17DATE:
07/26/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Melissa McMillenTIME COMPLETED:
12:50 PM
NARRATIVE
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On 7/26/2023, Licensing Program Analyst (LPAs) J. Helton and S. Sims conducted an unannounced case management visit due to recent unusual incident report received.

On July 12, 2023 a school age Teacher stuck his leg out and tripped a child. The Regional Program Manager reported the incident that occurred while the children were outside on the playground, there was 16 children and 2 teacher during transition. The child tripped and did not appear injured at the time. The internal injury report was not completed and not given to the parent on the day of the incident. The incident was not reported to Community Care Licensing because at the time of the incident, the child did not appear injured and Director was unaware of what actually had transpired. The child attended the rest of the day and was in good spirits, playing and eating, as well as the following day.

The following deficiencies were cited Type A citation for personal rights. (see LIC 809D):

LPA J. Helton informed Director Melissa McMillen that this report dated 7/26/2023 documents 1 Type A citations. 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.

Also, LPA J. Helton informed the Director Melissa McMillen to provide a copy of this licensing report dated 7/26/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 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.



A copy of this report was given and a notice of site visit, and must remain posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2023
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 07/26/2023 12:46 PM - It Cannot Be Edited


Created By: Jackie Helton On 07/26/2023 at 12:36 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: KIDDIE ACADEMY - S/A
FACILITY NUMBER: 483007934

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/26/2023
Section Cited
HSC
101223(a)(3)

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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.
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Teacher has been terminated.
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This violation is evident by:
Interview with teacher, admitting tripping child.
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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:Jackie Helton
LICENSING EVALUATOR SIGNATURE:
DATE: 07/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/26/2023


LIC809 (FAS) - (06/04)
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