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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045403835
Report Date: 04/05/2023
Date Signed: 04/05/2023 11:44:57 AM


Document Has Been Signed on 04/05/2023 11:44 AM - 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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:GRIDLEY CHILDREN'S CENTERFACILITY NUMBER:
045403835
ADMINISTRATOR:RODRIGUEZ, TERESAFACILITY TYPE:
850
ADDRESS:1567 BOOTH DR. ROOM 7TELEPHONE:
(530) 846-3850
CITY:GRIDLEYSTATE: CAZIP CODE:
95948
CAPACITY:24CENSUS: 20DATE:
04/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Teresa Rodriguez, Site SupervisorTIME COMPLETED:
11:50 AM
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On 4/5/2023 at 8:55am, a Required 1-Year inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. This program is operated by a public agency and a Title 5 funded program. The preschool is located in Room 7 and operates during the traditional school year, Monday–Friday; 8:30am-11:30am and 12:30pm-3:30pm. The facility was toured at 9:30am inside and outside. Site Supervisor Teresa Rodriguez and two teachers were supervising 20 children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises. The licensee has a waiver on file to be allowed for the outdoor activity space, and the terms of the waiver are being met. The outdoor activity space was cushioned with wood chips and free of hazards.

Five children's records were reviewed at 10:30am. Three staff records were reviewed at 9:55am.

Report continued: See LIC 809-C

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2023
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: GRIDLEY CHILDREN'S CENTER
FACILITY NUMBER: 045403835
VISIT DATE: 04/05/2023
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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.

A notice of site visit was provided 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 Site Supervisor Teresa Rodriguez.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023
LIC809 (FAS) - (06/04)
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