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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515404483
Report Date: 03/12/2020
Date Signed: 03/12/2020 04:19:12 PM

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:MILLS, HELANE FAMILY CHILD CARE HOMEFACILITY NUMBER:
515404483
ADMINISTRATOR:MILLS, HELANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 847-9493
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:14CENSUS: 7DATE:
03/12/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Helane MillsTIME COMPLETED:
04:25 PM
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An inspection was made to the facility by Licensing Program Analyst (LPA) Martinez. A review of staff records on 3/10/20 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently 2 adults living in the home. During today’s inspection the home and grounds were toured. The licensee was supervising 7 children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 7:15 to 5:30, Mon–Fri. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the three bedrooms of the home, and were made inaccessible by door knob cover. The home was observed to be clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. The licensee stated there is a working telephone in the home. The licensee’s pediatric CPR and First Aid certifications were reviewed, and expire on 7/20. The children use the backyard area as outside play and it is fully fenced. There is an in ground pool in the back yard. The pool is fully fenced with to meet title 22 regulation. Five children's records were reviewed at 3:55PM; current immunization's and Notification of Parent’s Rights forms were on file. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years. Notice of Site Visit shall be posted for 30 days from today's visit. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
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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