125407299-8-28-2023-13-CC-NWHR-CV5VRQ-20230828164019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 125407299
Report Date: 08/28/2023
Date Signed: 08/28/2023 04:40:25 PM

Document Has Been Signed on 08/28/2023 04:40 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	HURD, KAYCE FAMILY CHILD CARE HOME		FACILITY NUMBER:	125407299
ADMINISTRATOR:	HURD, KAYCE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 633-5111
CITY:	ARCATA	STATE: CA	ZIP CODE:	95521
CAPACITY:	14	CENSUS: 1	DATE:	08/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Kayce Hurd		TIME COMPLETED:	05:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/28/2023 at 3:30 PM, an annual inspection was made to the facility by Licensing Program Analysts (LPA) N. Wheeler and K. Lynch. At 3:30 PM the home was toured inside and outside. The Licensee was supervising one child and operating within the licensed capacity and ratio requirements. The facility’s operating hours are 7:00 AM to 5:30 PM, Monday–Friday. The floor plan submitted by the Licensee was reviewed and verified. The off-limits areas of the home are main bathroom, all outbuildings, detached garage, and were made inaccessible by child safety knob covers, gates, and/or locked/latched doors. Home utilizes central heat, and has a wood stove insert barricaded by fencing. The children use the side yard as the outdoor play area, and Licensee is outside with children due to unfenced areas. There were no pools or other bodies of water observed in the yard. Five children's records were reviewed at 4:15 PM. One staff record was also reviewed at 4:15 PM. There are currently two adults living in the home. The Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100 per day for a maximum of 5 days or, if the penalty is for a repeat violation, $100 per day for a maximum of 30 days per person, will be assessed if this regulation is violated. See next page

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Noah Wheeler	TELEPHONE: 530-895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: HURD, KAYCE FAMILY CHILD CARE HOME	FACILITY NUMBER: 125407299
	VISIT DATE: 08/28/2023

NARRATIVE

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LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care services by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. During the inspection, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

An exit interview was conducted with the Licensee Kayce Hurd, and a notice of site visit was given and must remain posted for 30 days.

No citations were issued during today's visit.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Noah Wheeler	TELEPHONE: 530-895-5033
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

LIC809 (FAS) - (06/04)

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