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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045406625
Report Date: 08/07/2019
Date Signed: 08/08/2019 11:02:44 AM

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:LAURA'S INFANT CENTERFACILITY NUMBER:
045406625
ADMINISTRATOR:PONCE, HERMELINDAFACILITY TYPE:
830
ADDRESS:380 EAST 5TH AVENUETELEPHONE:
(530) 343-1516
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY:21CENSUS: 19DATE:
08/07/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Kelli KollerTIME COMPLETED:
03:30 PM
NARRATIVE
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During an inspection made to the facility on 6/18/2019, Licensing Program Analyst's (LPA's) Laura Chavez and Sandy Husband discovered that the licensee failed to request a transfer of S#1 criminal record clearance prior to working at the facility. A $100.00 Civil Penalty has been assessed.

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.

The following violation of the California Code of Regulations, Title 22; Division 12, was cited: see LIC 809D. Appeal Rights were provided.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
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: LAURA'S INFANT CENTER
FACILITY NUMBER: 045406625
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/07/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/06/2019
Section Cited
CCR
101170(e)(2)
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Criminal Record Clearance: All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility, request a transfer of a criminal record clearance.

This requirement was not met as evidenced
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The licensee agrees to provide a written statement on how she will ensure that criminal record clearances are transferred prior to an individual working or volunteering at the facility.
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by: The licensee failing to request a transfer of S#1 criminal record clearance prior to working at the facility.
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The plan of correction shall be submitted to CCLD on or before 9/6/2019 indicating on date(s) of training to be provided to staff.


A $100.00 Civil Penalty has been assessed.
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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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019
LIC809 (FAS) - (06/04)
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