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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515407689
Report Date: 01/07/2021
Date Signed: 01/08/2021 11:31:35 AM

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:KAUR, RAJWINDER FAMILY CHILD CARE HOMEFACILITY NUMBER:
515407689
ADMINISTRATOR:KAUR, RAJWINDERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 441-9466
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:14CENSUS: 2DATE:
01/07/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Rajwinder KaurTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Martinez conducted an unannounced tele-visit with licensee Rajwinder Kaur. The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak. On 10/22/20 the licensee advised a representative of the Department that she once spanked a child after observing C1 sitting on top of C2. The licensee advised that she had notified the parent of C1 & C2 regarding the incident. Interviews with C3 indicated C3 had witnessed C1 get spanked by the licensee on the same occasion the licensee referred to. No date could be corroborated for when this incident occurred other than it occurred during daycare hours with other daycare children present.
Notice of Site Visit shall be posted for 30 days from today's visit.

The following violation(s) of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 809D. Appeal Rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC 9224 to be kept in each child's file.

SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2021
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: KAUR, RAJWINDER FAMILY CHILD CARE HOME
FACILITY NUMBER: 515407689
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/08/2021
Section Cited

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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing,
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medication or aids to physical functioning.
This requirement was not met as evidenced by; based on interviews it was determined the licensee spanked a child on the butt on one occasion. This is an immediate 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: 01/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/08/2021
LIC809 (FAS) - (06/04)
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