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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 041372888
Report Date: 03/10/2023
Date Signed: 03/10/2023 03:01:26 PM


Document Has Been Signed on 03/10/2023 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:CHILD DEVELOPMENT LABORATORYFACILITY NUMBER:
041372888
ADMINISTRATOR:HANSEN, JACKIEFACILITY TYPE:
850
ADDRESS:MODOC HALL - RM. 131TELEPHONE:
(530) 898-5865
CITY:CHICOSTATE: CAZIP CODE:
95929
CAPACITY:30CENSUS: 5DATE:
03/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Jackie Hansen, DirectorTIME COMPLETED:
03:15 PM
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On 3/10/23 at 1:30pm, an annual inspection was made to the facility by Licensing Program Analyst (LPA), E. Laird. This program is operated by public agency and a Title 5 funded program. Operating hours are 7:30am-5:00pm, Monday–Thursday and 7:30am-2:00pm Friday. The facility was toured at 2:45pm inside and outside and the floor and yard plan submitted by the licensee were verified. The facility representative and three teachers were supervising 5 children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises. The outdoor activity space was cushioned with sand and wood chips and free of hazards.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm


There were no deficiencies cited during today’s inspection.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Erica LairdTELEPHONE: 530-895-5045
LICENSING EVALUATOR SIGNATURE:
DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/10/2023
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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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: CHILD DEVELOPMENT LABORATORY
FACILITY NUMBER: 041372888
VISIT DATE: 03/10/2023
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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.

Exit interview conducted and report was reviewed with the facility representative, Jackie Hansen.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Erica LairdTELEPHONE: 530-895-5045
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2