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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115407078
Report Date: 02/08/2023
Date Signed: 02/23/2023 02:35:54 PM


Document Has Been Signed on 02/23/2023 02:35 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:GRIFFITH, JENNIFER FAMILY CHILD CARE HOMEFACILITY NUMBER:
115407078
ADMINISTRATOR:GRIFFITH, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 828-4218
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY:14CENSUS: 14DATE:
02/08/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Jennifer Griffith TIME COMPLETED:
03:15 PM
NARRATIVE
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On 2/8/2023 at approximately 2:35pm LPA Laura Chavez arrived to the family child care home located at 4209 Co Road K, Orland. Upon entry into the converted garage/play room LPA initially observed the licensee's assistant (A1) alone caring for 11 napping children. Moments later A1 stepped out to the front door to allow two additional children in who arrived to the home. While waiting for the licensee, A1 went out to retrieve an additional child who arrived in a school bus.The licensee arrived approximately 30 minutes later.

LPA Laura Chavez informed the licensee that this report dated 2/8/203 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Laura Chavez informed the licensee to provide a copy of this licensing report dated 2/8/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statements, must be placed in the child's file for verification.

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.



Appeal rights were provided, and an exit interview was conducted.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
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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Document Has Been Signed on 02/23/2023 02:35 PM - It Cannot Be Edited

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: GRIFFITH, JENNIFER FAMILY CHILD CARE HOME
FACILITY NUMBER: 115407078

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
02/09/2023
Section Cited
CCR
102416.5(e)

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Staffing Ratio and Capacity: If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
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The licensee plans to appeal the deficiency.
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This requirement is not met as evidenced by:

LPA observed the licensee's assistant (A1) alone caring for 13 children.
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A Civil Penalty for a Repeat Violation was 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: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/08/2023
LIC809 (FAS) - (06/04)
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