515402887-1-12-2023-13-CC-JHEN-CMZSWC-20230112131406

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 515402887
Report Date: 01/12/2023
Date Signed: 01/12/2023 01:14:12 PM

Document Has Been Signed on 01/12/2023 01:14 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:	KANG, CHARLENE FAMILY CHILD CARE HOME		FACILITY NUMBER:	515402887
ADMINISTRATOR:	KANG, CHARLENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 671-4029
CITY:	YUBA CITY	STATE: CA	ZIP CODE:	95991
CAPACITY:	14	CENSUS: 0	DATE:	01/12/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Charlene Kang		TIME COMPLETED:	01:18 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 1/12/23 at 12:25 PM, an annual inspection was made to the facility by Licensing Program Analyst (LPA), J. Helton. At 12:50 PM the home was toured inside and outside. The licensee and assistant were supervising no children, at this time, as they provide before and after school care only. The facility’s operating hours are 7:00 AM to 7:00 PM , Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The are not any rooms that are off-limits except the garage, which is made inaccessible by locking door. The children use the back yard as the outdoor play area and it is fully fenced. The play equipment is safe and appropriate. There were no pools or other bodies of water observed in the yard. 3 children's records were reviewed at 12:38 PM. 2 staff records were reviewed at 12:45 PM. There are currently 2 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, 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 $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. 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-and-resources/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. Continued on LIC809C

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Jackie Helton	TELEPHONE: 530-513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

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: KANG, CHARLENE FAMILY CHILD CARE HOME	FACILITY NUMBER: 515402887
	VISIT DATE: 01/12/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

There were no deficiencies cited during today’s inspection.

Exit interview conducted and report was reviewed with the licensee Charlene Kang.

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.
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 Virrueta	TELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Jackie Helton	TELEPHONE: 530-513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2023

LIC809 (FAS) - (06/04)

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