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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 123007037
Report Date: 08/11/2022
Date Signed: 08/11/2022 12:32:57 PM


Document Has Been Signed on 08/11/2022 12:32 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:CHILDREN'S COTTAGE PRESCHOOL, THEFACILITY NUMBER:
123007037
ADMINISTRATOR:MCCUTCHEN, ROSEFACILITY TYPE:
850
ADDRESS:1807 HARRISON AVENUETELEPHONE:
(707) 445-8119
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY:30CENSUS: 20DATE:
08/11/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mercedes PorterTIME COMPLETED:
01:00 PM
NARRATIVE
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LPA Lynch arrived at the facility today for the purpose of amending a recent Licensing report from 07/25/22, and met with the Site Supervisor. At today's visit, the facility was cited for a buildings and grounds violation for at least one child (C3) was recently able to open the back courtyard gate unassisted and left the facility into the back alleyway. Disclosures from witness interviews also provided that the latch on the gate was easily reached and opened by older children at the facility, and that the gate has sometimes been left open during pickup/dropoff time. This is a potential risk to children in care, and a Type B deficiency has been cited. See LIC 809-D. Exit interview conducted, appeal rights provided, and notice of site visit posted.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Kiriko LynchTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 08/11/2022 12:32 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: CHILDREN'S COTTAGE PRESCHOOL, THE
FACILITY NUMBER: 123007037

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2022
Section Cited

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Buildings and Grounds
(a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

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The requirement was not met by at least one child (C3) in attendance was recently able to unlatch and exit a back facility gate into the alleyway while a teacher was supervising the child.
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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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Kiriko LynchTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2022
LIC809 (FAS) - (06/04)
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