475403887-10-17-2022-13-CC-NCUM-CK6RMR-20221013130907

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 475403887
Report Date: 10/13/2022
Date Signed: 10/17/2022 07:41:34 AM

Document Has Been Signed on 10/17/2022 07:41 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:	SISKIYOU (SCOE) INFANT		FACILITY NUMBER:	475403887
ADMINISTRATOR:	GIERTZ, CHEZ		FACILITY TYPE:	830
ADDRESS:	1 CHILD'S WAY		TELEPHONE:	(530) 842-8493
CITY:	YREKA	STATE: CA	ZIP CODE:	96097
CAPACITY:	8	CENSUS: 0	DATE:	10/13/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Cassie Mecina		TIME COMPLETED:	01:20 PM

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On 10/13/22 at 11:50 am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), N. Cunningham. This is a state preschool and Title 5 funded program.

The facility’s providing distance learning Monday-Friday, 8:30-3:30, January - December. The facility was toured at 1:00 pm inside and outside and the floor and yard plan submitted by the licensee were verified. There are no pools or bodies of water on the premises. The outdoor activity space was cushioned with sand and free of hazards.

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.

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

Continued on 809C

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Nicolette Cunningham	TELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

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: SISKIYOU (SCOE) INFANT	FACILITY NUMBER: 475403887
	VISIT DATE: 10/13/2022

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There were no deficiencies cited during today’s inspection. LPA was unable to review files due to scheduling conflict; LPA will return on another date to review files.

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, Elizabeth Robinson.

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: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

LIC809 (FAS) - (06/04)

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