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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515407026
Report Date: 03/13/2020
Date Signed: 03/13/2020 02:26:36 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:TEEL, CAMILLE FAMILY CHILD CARE HOMEFACILITY NUMBER:
515407026
ADMINISTRATOR:TEEL, CAMILLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 218-3807
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:14CENSUS: 5DATE:
03/13/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Camille TeelTIME COMPLETED:
02:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Martinez and Grisak conduced an unannounced visit and met with the licensee Camille Teel. It was determined through interviews that the provider, Camille had been made aware of suspected abuse and did not report it to local law enforcement, CCLD, or CPS. On 2/4/20 LPA Martinez conducted an interview with the provider. The provider, Camille stated that she would not have joked about the situation if she had believed it really happened. Camille stated at that time she was made aware about an incident and discussed it in public jokingly with other providers. I, LPA Martinez questioned when she was first made aware of the incident and was told in November.

It should be noted Camille Teel's Mandated Reporter training was current. The procedures for reporting suspected abuse was discussed with the licensee by LPA Martinez on 2/4/20. Based on the information above, The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020
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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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: TEEL, CAMILLE FAMILY CHILD CARE HOME
FACILITY NUMBER: 515407026
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2020
Section Cited

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(b)(1) A report shall be made to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence during the operation of a family day care home of any of the following events (C) Any unusual incident or child absence that threatens the
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physical or emotional health or safety of any child.
This requirement was not met as evidenced by; Based on interviews the licensee was made aware of suspected abuse sometime in November of 2019 and did not report to the department. This is a potential health and safety risk to children in care.
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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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2020
LIC809 (FAS) - (06/04)
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