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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045406197
Report Date: 09/23/2025
Date Signed: 10/14/2025 09:58:56 AM

Document Has Been Signed on 10/14/2025 09:58 AM - 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:KIDSPARKFACILITY NUMBER:
045406197
ADMINISTRATOR/
DIRECTOR:		LEFKOWITZ, DIONNAFACILITY TYPE:
850
ADDRESS:2477 FOREST AVE., STE. 190TELEPHONE:
(530) 894-6800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 17DATE:
09/23/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:48 PM
MET WITH:Dionna LefkowitzTIME VISIT/
INSPECTION COMPLETED:
04:57 PM
NARRATIVE
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This is an amended version of the report originally provided on 9/23/25.

On 9/23/25 Licensing Program Analyst (LPA) Tammy Dutra conducted an unannounced case management investigation regarding an unusual incident that occurred on 8/28/25, and was reported on 9/5/25 where a child in care (C1) was injured on the indoor play area referred to as the “mountain of energy”. Staff (S1) reported that C1 was running on the mountain, and tripped going up the stairs. After cleaning C1’s mouth, S1 noticed that C1 had bit their lip and two teeth were pushed back. S1 administered first aid and called C1’s parent. The parent sought medical and dental care, and C1 ended up having two teeth pulled.

On 9/6/25 LPA interviewed the parent of C1 (P1). P1 provided documentation from the physician and dentist regarding the injury. P1 stated that they were happy with reporting and the first aid care their child received at the facility.

NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Tammy Dutra
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KIDSPARK
FACILITY NUMBER: 045406197
VISIT DATE: 09/23/2025
NARRATIVE
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On 9/23/25 LPA visited the facility and interviewed S1. S1 stated that they were in charge of supervising 10 children in the “mountain” area when the incident occurred. C1 was running on the “mountain” when they were injured. S1 stated that preschool and school age children can only play on the mountain with their age group. The staff put up a sign when it is time for the blue crew (school age) to play. S1 stated that they used to allow children to play tag on the mountain but have updated the rules since the incident.

LPA also interviewed the licensee. The licensee stated that they have rules for using the mountain. Children are separated by age and gender. The “blue crew” is children age 6 and older. They also limit the number of children that are on the mountain at the same time to 10 big kids.

LPA received the facility’s updated “Mountain of Energy” policy from the Licensee on 9/29/25. The policy included that preschool and school-age children cannot commingle, that tag or dodgeball is not allowed, and to not have more than 12 children on the mountain at one time.

During the visit on 9/23/25 the facility was toured and the “Mountain of Energy” was observed. It was observed that there was an adult size office chair placed in the bottom, right area of the mountain for staff to sit while children are on the mountain.

NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Tammy Dutra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025
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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: KIDSPARK
FACILITY NUMBER: 045406197
VISIT DATE: 09/23/2025
NARRATIVE
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Based on interviews and record reviews, it was determined that the staff did not ensure that the “mountain” was being used in a safe manner when the injury occurred. The child that was injured was allowed to run on the tall stairs and tunnel area when the injury occurred. It was also observed that C1 was below 6 years of age and should not have been part of the “blue crew” according to the Licensee’s policy of 6 and older. The facility’s school-age license also states that the school-age program is for ages 6-12. The following violation of the California Code of Regulations, Title 22; Division 12, is being cited CCR 101223(a)(2): Personal Rights (see LIC 809D).

A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided.

Exit interview conducted and report was reviewed with the licensee Dionna Lefkowitz.

NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Tammy Dutra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/14/2025 10:16 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 10/14/2025 08:30 AM


Created By: Tammy Dutra On 09/23/2025 at 03:57 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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: KIDSPARK
FACILITY NUMBER: 045406197

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
09/23/2025
Section Cited
CCR
101223(a)(2)

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(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The licensee has updated the “Mountain of Energy” policy and agrees to share it with all staff.
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Based on observation and record review, the licensee did not comply with the section cited above C1 which poses an immediate health, safety, or personal rights 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.
Erin Virrueta
NAME OF LICENSING PROGRAM MANAGER:
Tammy Dutra
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2025


LIC809 (FAS) - (06/04)
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