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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483007543
Report Date: 09/23/2022
Date Signed: 09/23/2022 01:34:45 PM


Document Has Been Signed on 09/23/2022 01:34 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:GRIFFIN, DEBRA FAMILY CHILD CARE HOMEFACILITY NUMBER:
483007543
ADMINISTRATOR:GRIFFIN, DEBRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 365-6766
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY:14CENSUS: 3DATE:
09/23/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Debra GriffinTIME COMPLETED:
01:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) J. Helton conducted an unannounced case management visit to follow up on an immediate exclusion notice that was sent to licensee. Licensee received notice on 9/16/2022. During the visit, licensee stated that Marilynbrittany Harrigan was an assistant and had not been working at the facility since August 2022. licensee understands that she must have the addendum to notification of parent's right (regarding removal/exclusion) LIC 995B signed by each parent of enrolled child and will keep the document in the file. Licensee understands that the assistant cannot return to the facility.

Exit interview was conducted with licensee Debra Griffin.

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.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Jackie HeltonTELEPHONE: 530-513-0993
LICENSING EVALUATOR SIGNATURE:
DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/23/2022
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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