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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125407299
Report Date: 05/26/2020
Date Signed: 05/26/2020 03:28:58 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:HURD, KAYCE FAMILY CHILD CARE HOMEFACILITY NUMBER:
125407299
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
05/26/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Kayce HurdTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Kiriko Lynch conducted a Licensee initiated case management inspection with the Licensee for an application request for increased capacity that was received by the Department. The Licensee has requested a capacity increase for a large family child care home for up to 14 children. The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak.

The LPA toured the facility indoors and outdoors. The Licensee was supervising 1 child and was operating within the limitations of her current license. LPA reviewed the capacity and ratio for a large FCCH license, and the Licensee acknowledged she understood the capacity and ratio requirements. The LPA also reviewed the Lead Exposure Testing Flyer with the Licensee.

Fire clearance was approved on 03/05/2020 by the local fire authority. The capacity increase is approved as of today 05/26/2020. An exit interview was conducted with the Licensee.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Kiriko LynchTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2020
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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