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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455407905
Report Date: 08/22/2023
Date Signed: 08/22/2023 10:50:27 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
07/28/2023 and conducted by Evaluator Jaime Snow
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20230728090428
FACILITY NAME:INTHARASOMBUT, NATECHONNANEE FAMILY CHILD CAREFACILITY NUMBER:
455407905
ADMINISTRATOR:INTHARASOMBUT, NATECHONNANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 355-9976
CITY:SHASTA LAKESTATE: CAZIP CODE:
96019
CAPACITY:14CENSUS: DATE:
08/22/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH: ‘Natalie’ Natechonnanee IntharasombutTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Licensee leaves children in high chairs as a form of discipline
INVESTIGATION FINDINGS:
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On August 22, 2023 at TIME, Licensing Program Analyst (LPA) Snow conducted an unannounced complaint inspection and met with ‘Natalie’ Natechonnanee Intharasombut, Licensee.
It was also alleged that the licensee leaves children in highchairs as a form of discipline. On August 2, 2023 the licensee said she has used a highchair for timeouts for 3 of the children but has only up them in the chairs for a few minutes. Licensee is taking behavioral classes at SCOE and has started using other forms or redirection. The LPA interviewed witnesses including 4 parents, 3 children and 2 staff; none of the witnesses reported excessive time out however the licensee and all but 2 of the witnesses were aware that timeout was in a chair and one witness reported that a 5 year old had also received timeout in the highchair therefore the allegation is substantiated. continued
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
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 6
Control Number 13-CC-20230728090428
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: INTHARASOMBUT, NATECHONNANEE FAMILY CHILD CARE
FACILITY NUMBER: 455407905
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/25/2023
Section Cited
CCR
102423(a)(1)
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Personal rights to be treated with dignity in his/her personal relationship with staff and other persons.
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The licensee has stopped using the highchair since the complaint was opened on 8/2/23. Licensee agrees to send a statement about the new discipline procedure and the staff names and dates they were advised on the new discipline. Due by 8/25/23
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This requirement is not met as evidenced by: witness and licensee statements which poses an immediate Health and Safety risk to children in care.
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Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. Due by 8/21/23
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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: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
07/28/2023 and conducted by Evaluator Jaime Snow
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20230728090428

FACILITY NAME:INTHARASOMBUT, NATECHONNANEE FAMILY CHILD CAREFACILITY NUMBER:
455407905
ADMINISTRATOR:INTHARASOMBUT, NATECHONNANFACILITY TYPE:
810
ADDRESS:1413 MUSSEL SHOALS AVE.TELEPHONE:
(530) 355-9976
CITY:SHASTA LAKESTATE: CAZIP CODE:
96019
CAPACITY:14CENSUS: DATE:
08/22/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH: ‘Natalie’ Natechonnanee IntharasombutTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff is not criminal record cleared
INVESTIGATION FINDINGS:
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It was alleged that Staff (A1) is not criminal record cleared. The licensee was interviewed at noon on 8/2/23 and denied that A1 is staff. Licensee said A1 walks her children home from school and sometimes visits but doesn’t supervise daycare children. The LPA observe 2 other staff but A1 was not present at the facility during the inspections on 8/2/23 & 8/22/23. The LPA observed that A1 is in process. 9 witnesses were interviewed including 4 parents, 2 staff and 3 children and all denied the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. An exit interview was conducted. The Notice of Site Visit must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 13-CC-20230728090428
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: INTHARASOMBUT, NATECHONNANEE FAMILY CHILD CARE
FACILITY NUMBER: 455407905
VISIT DATE: 08/22/2023
NARRATIVE
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Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted.

The following violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

Notice of Site Visit shall be posted for 30 days from today’s visit.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6