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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 515408137
Report Date: 04/05/2023
Date Signed: 06/02/2023 11:13:46 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
03/29/2023 and conducted by Evaluator Jackie Helton
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20230329094027
FACILITY NAME:BROWN, KIMBERLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
515408137
ADMINISTRATOR:BROWN, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 774-3368
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:14CENSUS: 10DATE:
04/05/2023
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Kimberly BrownTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Uncleared adults
INVESTIGATION FINDINGS:
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On April 5, 2023 at 10:30 AM, Licensing Program Analyst (LPAs) J. Helton and P. DiGenova conducted an unannounced complaint inspection, and met with licensee Kimberly Brown. It was alleged that licensee has had uncleared adults in the home.

The licensee was interviewed during the visit. Licensee stated she is never out of ratio and while she was looking for a new assistant, she had 2 other people helping some days to ensure her ratio was accurate.

Based on interview with Licensee and a review of Guardian background clearances, it was determined that there have been uncleared adults assisting with child supervision.

LPAs informed licensee Kimberly Brown that this report dated 4/5/2023 document(s) 1 Type A citation, which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
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-20230329094027
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: BROWN, KIMBERLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 515408137
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/06/2023
Section Cited
HSC
102370(d)(1)
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Criminal Records Clearance (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1 )Obtain a California clearance or a criminal record exemption as required by the Department.
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Licensee cannot use assistant until after the livescan clearance has been completed. Licensee must operate as a small family child care home unless she can obtain another assistant that is currently cleared.
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This requirement is not met as evidence by: Based on observation and interview, the licensee was/has operating with an uncleared adult in the facility, which poses an immediate health, safety, or personal rights risk to persons 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: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20230329094027
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: BROWN, KIMBERLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 515408137
VISIT DATE: 04/05/2023
NARRATIVE
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Also, LPAs informed the licensee to provide a copy of this licensing report dated 4/5/2023 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.

Exit interview conducted and report was reviewed with the licensee Kimberly Brown.


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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3