<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515404616
Report Date: 01/17/2024
Date Signed: 01/18/2024 11:49:15 AM


Document Has Been Signed on 01/18/2024 11:49 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:CREATIVE KIDS INFANTS - LINCOLN RD.FACILITY NUMBER:
515404616
ADMINISTRATOR:LIGHTLE, MICHELLEFACILITY TYPE:
830
ADDRESS:1060 LINCOLN ROAD, SUITE D & FTELEPHONE:
(530) 751-9217
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:16CENSUS: 12DATE:
01/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Michelle LightleTIME COMPLETED:
10:00 AM
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 January 17, 2024, at 9:25am, Licensing Program Analyst (LPA) Laura Chavez conducted a case management inspection and met with Licensee Michelle Lightle. At 9:35am LPA toured the facility at which time LPA observed four infants (Infants #1, #2, #3, and #4) sleeping in cribs in the Teddy Bear classroom covered with blankets.

The following deficiency was cited: 101439.1(f) Infant Care Center Sleeping Equipment (see LIC809D).



Appeal Rights and a Notice of Site Visit were given. The Notice of Site Visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.00. All licensing reports are public information and must be made available upon request for at least three years.

An exit interview was conducted, and the report was reviewed with Licensee/Director Michelle Lightle.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 01/18/2024 11:49 AM - It Cannot Be Edited

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: CREATIVE KIDS INFANTS - LINCOLN RD.
FACILITY NUMBER: 515404616

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/16/2024
Section Cited
CCR
101439.1(f)

1
2
3
4
5
6
7
Infant Care Center Sleeping Equipment: Cribs shall be free from all loose articles and objects, including blankets and pillows.
This requirement is not met as evidenced by: LPA observing 4 sleeping infants covered with blankets.
1
2
3
4
5
6
7
Licensee agrees to have all staff view training provided on the Department's website: https://ccld.childcarevideos.org/child-care-center regarding safe sleep as well as have all staff review regulations regarding safe sleep for infants.
8
9
10
11
12
13
14
8
9
10
11
12
13
14
Licensee agrees to provide a sign-in sheet of staff who were provided the training and review of safe sleep regulations as well as a written statement on how the facility will implement requirements for safe sleep. The plan of correction shall be submitted to CCLD on or before 2/16/2024.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2