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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 573615111
Report Date: 04/14/2022
Date Signed: 04/14/2022 03:36:23 PM

Document Has Been Signed on 04/14/2022 03:36 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:HUTCHISON CHILD DEVELOPMENT CENTERFACILITY NUMBER:
573615111
ADMINISTRATOR:CINDER,DANIELLEFACILITY TYPE:
830
ADDRESS:1055 EXTENSION CENTER DRIVETELEPHONE:
(530) 752-7676
CITY:DAVISSTATE: CAZIP CODE:
95616
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 19DATE:
04/14/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Chantel Pratt, Field DirectorTIME COMPLETED:
03:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Salene Mayberry and Licensing Program Manager (LPM) Bettina Engelman met with Field Director Chantel Pratt to follow up on a Unusual Incident Report (UIR) submitted to Community Care Licensing on April 11, 2022.

During today's visit the facility was toured. Licensing staff also interviewed the Field Director who was present during the incident.

Licensing staff learned that on 4/4/22, during staff break transitions, there was a failure between two teachers to communicate who would be remaining inside to watch three children who were napping. As a result of the miscommunication three children were left unattended and without the visual supervision of a staff member for a period of 2-3 minutes.

A Type A deficiency was cited on the subsequent page (809-D) of this report.

A facility evaluation report was reviewed and discussed with Field Director. Exit interview was conducted. LPA posted a Notice of Site Visit which must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Salene Mayberry
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 04/14/2022 03:36 PM - It Cannot Be Edited


Created By: Salene Mayberry On 04/14/2022 at 02:53 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: HUTCHISON CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 573615111

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/14/2022
Section Cited
CCR
101229(a)(1)

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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.

This requirment was not met as evidened by:
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Field Director conducted additional in-person and virtual training for the classroom the day after the incident and increased monitoring of staff. Disciplinary measures were taken with staff. Staff were reminded of the importance of name to face tracking even when children are napping.
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LPA learned that on 4/4/22, during staff break transitions, three children were left unattended and without the visual supervision of a staff member for a period of 2-3 minutes.
This is an immediate risk to the health and safety of children.
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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:Bettina Engelman
LICENSING EVALUATOR NAME:Salene Mayberry
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2022


LIC809 (FAS) - (06/04)
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