045407522-7-21-2025-13-CC-TDUA-DJSTDV-20250721143858

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 045407522
Report Date: 07/21/2025
Date Signed: 07/21/2025 02:39:04 PM

Document Has Been Signed on 07/21/2025 02:39 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	CHICO CHRISTIAN SCHOOL AGE CENTER		FACILITY NUMBER:	045407522
ADMINISTRATOR/ DIRECTOR:	ALLEN, BRONWYN		FACILITY TYPE:	840
ADDRESS:	2801 NOTRE DAME BOULEVARD		TELEPHONE:	5308798988
CITY:	CHICO	STATE: CA	ZIP CODE:	95928
CAPACITY: 25	TOTAL ENROLLED CHILDREN: 25	CENSUS: 18	DATE:	07/21/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Bronwyn Allen		TIME VISIT/ INSPECTION COMPLETED:	02:49 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	An unannounced case management inspection was conducted today at 1:30pm by Licensing Program Analyst (LPA), Tammy Dutra. LPA met with facility representative Bronwyn Allen in response to an Unusual Incident Report received by the Department on 7/9/25. While climbing on the climbing structure C1 fell and cut their chin. Follow up care involved C1 receiving stitches. The facility representative was interviewed on 7/21/25 at 1:52pm and stated that on 7/8/25 at approximately 10:59am a child in care, C1 was injured. Director was not at the facility but received a call from the teacher stating C1 had sustained an injury on the playground. First aid was applied and parents were notified. C1 left the center and received stitches to close the wound. C1 was on vacation and returned to the center on July 14th. One staff member and one child were interviewed on 7/21/25 and stated that C1 was playing on a metal dome climbing structure and lost their balance causing them to slip and hit their chin which resulted in a cut. The cut required medical attention and stitches were placed to close the wound. C1 indicated the accident could have been due to the type of shoes worn that day.

NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Tammy Dutra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025

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: CHICO CHRISTIAN SCHOOL AGE CENTER	FACILITY NUMBER: 045407522
	VISIT DATE: 07/21/2025

NARRATIVE

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During today’s inspection, the facility was toured and two staff were supervising 18 children. LPA observed children playing on the playground and C1 re-enacted how the incident occurred. LPA reviewed staffing levels and ratio requirements from the date of the incident and determined the facility was operating per Title 22 regulations. Director has met with teachers to coach on using preventative language to slow children down and prevent future incidents.

LPA reached out to C1's parent and they indicated they felt it was an accident and C1 has recovered with no issues.

Based on the interviews conducted and ratio requirements being met LPA determined this incident was an accident. No further investigation is needed.

Exit interview conducted and report was reviewed with the facility representative Bronwyn Allen. Appeal Rights were provided.

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.

NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Tammy Dutra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025

LIC809 (FAS) - (06/04)

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