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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045402687
Report Date: 08/13/2019
Date Signed: 08/13/2019 03:52:14 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:HAGGARD, JESSICA FAMILY CHILD CARE HOMEFACILITY NUMBER:
045402687
ADMINISTRATOR:HAGGARD, JESSICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 343-3038
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:14CENSUS: 13DATE:
08/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:Jessica HaggardTIME COMPLETED:
04:00 PM
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An unannounced annual inspection was made to the facility by Licensing Program Analysts (LPAs), Sandy Husband and Carrie Wisehart. A review of staff records on 8/13/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently 2 adults living in the home.

During today’s inspection the home and grounds were toured. The licensee and an assistant were supervising 13 children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 7:00 AM to 5:30 PM, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are and Master Bedroom, Master Bath, Pantry, office and both garages. These were made inaccessible by door locks. The home is clean, orderly and comfortable. There are safe toys and equipment available for children. There is a working telephone in the home. The licensee has current pediatric CPR and First Aid certification, which expire on 11/30/20. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. Poisons are locked in the outdoor shed. The fireplace has been made inaccessible and licensee stated the fireplace will remain
(Continued on LIC 809-C)
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: HAGGARD, JESSICA FAMILY CHILD CARE HOME
FACILITY NUMBER: 045402687
VISIT DATE: 08/13/2019
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 (Continued from LIC 809)
non-operational during daycare hours. An emergency drill was conducted within the past 6 months on 5/10/19. There is a working smoke detector, carbon monoxide detector and charged fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's inspection. The children use the back yard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed in the yard. 13 children's records were reviewed at 2:20 PM; required emergency information was observed to be on file. The licensee is not providing Incidental Medical Services (IMS) to children in care. The Incidental Medical Services (IMS) policy was discussed with the licensee. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

The following information regarding ADA was provided: US Department of Justice 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, www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
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