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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125401106
Report Date: 05/16/2024
Date Signed: 11/22/2024 03:01:42 PM

Document Has Been Signed on 11/22/2024 03:01 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:HEAD START - ALICE BIRNEYFACILITY NUMBER:
125401106
ADMINISTRATOR/
DIRECTOR:		FORD, DELORISFACILITY TYPE:
850
ADDRESS:717 SOUTH AVENUETELEPHONE:
(707) 442-8977
CITY:EUREKASTATE: CAZIP CODE:
95503
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 21DATE:
05/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Deloris FordTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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An unannounced case management inspection was conducted today at 9 AM by Licensing Program Analysts (LPA) Kiriko Lynch and Noah Wheeler. LPAs met with facility representative Deloris Ford. In response to an Unusual Incident Report received by the Department on 04/18/24. It was reported that a staff (S1) slapped a child (C1) on the hand while assisting children with handwashing.

The facility representative was interviewed on 04/24/24, and stated that during the first week or two of April 2024, a witness (S2) reported that a teacher (S1) was assisting two children (C1, C2) with handwashing and slapped one child (C1) on the hand while the child was turning around in response to the other child (C2) poking the child.

Seven staff and five children were interviewed at the facility on 04/24/24 and 05/16/24, and there were several staff disclosures of S1 using inappropriate physical methods with children at the facility, for example, hand-slapping, vigorously cradle-carrying/rocking children, and tugging/carrying child by arms to the restroom while child’s legs were limp.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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 11/22/2024 03:02 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 11/20/2024 05:00 PM


Created By: Kiriko Lynch On 05/16/2024 at 11:28 AM
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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: HEAD START - ALICE BIRNEY
FACILITY NUMBER: 125401106

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2024
Section Cited
CCR
101223

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Personal Rights - (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
(2) To be accorded safe, healthful and comfortable accommodations,
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POC cleared at time of visit, Licensee previously corrected deficiency as noted in report.
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furnishings and equipment to meet his/her needs. (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...
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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:Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:
DATE: 05/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2024


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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: HEAD START - ALICE BIRNEY
FACILITY NUMBER: 125401106
VISIT DATE: 05/16/2024
NARRATIVE
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During the inspection visits, the facility was toured, and records related to the incident were obtained. LPA also received further information from the Licensee regarding the incident and subsequent steps they took to prevent further incidents, including their internal investigation, speaking to involved parents/guardians, personal rights staff training, and personnel action. LPA also observed appropriate care and supervision at the facility during the subsequent visits.

Based on the information reported and interviews conducted with staff, the following deficiency is being cited on the LIC809-D. LPA Lynch informed facility representative that this report dated 05/16/24 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. Also, LPA Lynch informed the facility representative to provide a copy of this licensing report dated 05/16/24 that documents any Type A citation 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 facility representative Deloris Ford. 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.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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