455402531-9-13-2022-13-CC-NCUM-CJ8MM5-20220913094323

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 455402531
Report Date: 09/09/2022
Date Signed: 09/13/2022 09:43:29 AM

Document Has Been Signed on 09/13/2022 09:43 AM - 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:	MILLVILLE PRESCHOOL		FACILITY NUMBER:	455402531
ADMINISTRATOR:	JULIE GIFFORD		FACILITY TYPE:	850
ADDRESS:	8570 BROOKDALE ROAD		TELEPHONE:	(530) 547-4471
CITY:	MILLVILLE	STATE: CA	ZIP CODE:	96062
CAPACITY:	23	CENSUS: 4	DATE:	09/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Julie Gifford, Director		TIME COMPLETED:	12:30 PM

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On 09/09/2022 at 9:30am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), N. Cunningham. Operating hours are 8:00 am - 2:30 pm, Monday - Friday; the facility follows the school schedule. with the exception of operating a full day on Mondays. The facility was toured at 10am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in classroom 2 on the Millville Elementary School campus.

The facility representative was/were supervising four children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises.

Eight children's records were reviewed at 11:00am. One staff records was reviewed at 11:30am.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Nicolette Cunningham	TELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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: MILLVILLE PRESCHOOL	FACILITY NUMBER: 455402531
	VISIT DATE: 09/09/2022

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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: http://www.ada.gov/childqanda.htm.

There were no deficiencies cited during today’s inspection.

A 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.

Exit interview conducted and report was reviewed with facility representative, Julie Gifford.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Nicolette Cunningham	TELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC809 (FAS) - (06/04)

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