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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115403997
Report Date: 11/01/2019
Date Signed: 11/01/2019 12:00:32 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:HAMILTON CITY EARLY HEAD STARTFACILITY NUMBER:
115403997
ADMINISTRATOR:VILLALBA, MARGARITAFACILITY TYPE:
830
ADDRESS:HWY 32 & LOS ROBLES ST.TELEPHONE:
(530) 826-0310
CITY:HAMILTON CITYSTATE: CAZIP CODE:
95951
CAPACITY:18CENSUS: 8DATE:
11/01/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Site Supervisor/Primary Care Teacher Ofelia Barajas-CruzTIME COMPLETED:
12:15 PM
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On 11/01/2019 from 9:00am thru 12:15pm Licensing Program Analyst (LPA) conducted a Case Management inspection due to this agencies timely self reported Unusual Incident Report (UIR). The incident date was 10/31/2019 and was in regards to a report of a staff and child interaction.

LPA toured the facility, interviewed staff and reviewed and obtained applicable records. Due to children's ages none were interviewed.

During today's inspection, LPA observed that adequate care and supervision was being provided including that staffing ratios were being met and the facility was operating within the licensed capacity.

LPA will continue this Case Management pending further inquires into the above reported UIR.

This report was reviewed and discussed with Site Supervisor.

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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David WilsonTELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019
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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