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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475407772
Report Date: 12/19/2024
Date Signed: 12/19/2024 12:54:34 PM

Document Has Been Signed on 12/19/2024 12:54 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:CHRYSALIS CHILD CARE CENTERFACILITY NUMBER:
475407772
ADMINISTRATOR/
DIRECTOR:		DOOLEY, JENNYFACILITY TYPE:
850
ADDRESS:316 SHERMAN STREETTELEPHONE:
(530) 842-7474
CITY:YREKASTATE: CAZIP CODE:
96097
CAPACITY: 60TOTAL ENROLLED CHILDREN: 40CENSUS: 27DATE:
12/19/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Jenny DooleyTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 12/19/24 @ 11:00am, an unannounced inspection was conducted by Licensing Program Analyst (LPA) Nicolette Cunningham in response to an unusual incident that was self-reported by the licensee. Community Care Licensing Division (CCLD) was notified within 24 hours and unusual incident report was sent in writing within the 7 days as required. The incident occurred on 10/1/24 at approximately 3:50pm when one staff (S1) escorted three children inside the building for a bathroom break. S1 exited the building with two child (C1-2) and did not notice the third child (C3) remained in the building. Two parents (P1-P2) observed C3 standing at the door waiting to go outside and opened the door to the playground so C3 could reunite with their teacher. Child gates prohibited the child from departing the building and walking to the parking lot/ street. LPA photographed the area where the parents found C3 unsupervised (photograph 1). Staff estimate the child was without supervision for less than three minutes. The licensee reported that she notified C3 parent at pickup. The licensee also reported the child was not injured.

The following violation of the California Code of Regulations, Tittle 22: Division 12 was observed: absence of supervision (see LIC 809D).

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was given and must remain posted for 30 days. Appeal rights were provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2024
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 12/19/2024 12:54 PM - It Cannot Be Edited


Created By: Nicolette Cunningham On 12/19/2024 at 12:39 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
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: CHRYSALIS CHILD CARE CENTER
FACILITY NUMBER: 475407772

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/30/2024
Section Cited
CCR
101229(a)(1)

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(a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

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Licensee stated she will research training and inform LPA Cunningham of the training she selects by 12/30/24. The licensee stated once the training is complete she will send LPA training notes with a list of staff that attended.
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This was not met as evidence by: based on interviews and record review, C3 was unsupervised for less than three minutes in the classroom. This poses a potential 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.
SUPERVISOR'S NAME:Erin Virrueta
LICENSING EVALUATOR NAME:Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2024


LIC809 (FAS) - (06/04)
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