471374536-5-23-2022-13-CC-NCUM-CEPTLC-20220523144919

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 471374536
Report Date: 05/20/2022
Date Signed: 05/23/2022 02:49:30 PM

Document Has Been Signed on 05/23/2022 02:49 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:	SHADY CREEK CHILDREN'S CENTER		FACILITY NUMBER:	471374536
ADMINISTRATOR:	TURNER, JEANNE		FACILITY TYPE:	850
ADDRESS:	405 MILL STREET		TELEPHONE:	(530) 926-0867
CITY:	MT. SHASTA	STATE: CA	ZIP CODE:	96067
CAPACITY:	40	CENSUS: 10	DATE:	05/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Jeanne Turner,. Licensee		TIME COMPLETED:	03:40 PM

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On 05/20/22 at 2:20pm, an annual\ inspection was made to the facility by Licensing Program Analyst (LPA), N. Cunningham. The program operates January - December, Monday–Friday, 7:00am-5:30pm. The facility was toured at 2:30pm inside and outside and the floor and yard plan submitted by the licensee were verified. The licensee and two staff were supervising ten children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises. The property borders Shady Creek which is made inaccessible with a chain length fence. The outdoor activity space was cushioned with gravel and free of hazards.

Licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Nicolette Cunningham	TELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022

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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: SHADY CREEK CHILDREN'S CENTER	FACILITY NUMBER: 471374536
	VISIT DATE: 05/20/2022

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During today's inspection, LPA was unable to review files due to time constraint. LPA will return to conduct a continuation inspection in order to review files.

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 the licensee Turner.

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) 895-4325
LICENSING EVALUATOR NAME: Nicolette Cunningham	TELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022

LIC809 (FAS) - (06/04)

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