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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 521370103
Report Date: 10/23/2019
Date Signed: 10/23/2019 01:16:50 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:TEHAMA CENTERFACILITY NUMBER:
521370103
ADMINISTRATOR:WILLIAMS, TRISHAFACILITY TYPE:
850
ADDRESS:650 3RD STREETTELEPHONE:
(530) 529-1500
CITY:TEHAMASTATE: CAZIP CODE:
96090
CAPACITY:44CENSUS: 29DATE:
10/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Trisha Williams TIME COMPLETED:
01:30 PM
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An Annual/Random inspection was conducted at the facility by Licensing Program Analyst (LPA), David Wilson. The facility file was reviewed prior to this inspection on 10/17/2019. This is a Head Start program operated by NCCDI. Operating hours are 8am-4pm, Mon-Fri. The facility if closed late June - early Sept. The facility was toured inside and outside and the floor and yard plan submitted by the licensee were verified. The items which could pose a danger to children (such as detergents, cleaning compounds and medications) were observed to be inaccessible to children. Director Williams stated poisons are locked in the janitor closet that LPA observed with a key lock located in a common hallway within the facility. The facility was free of flies, insects and rodents. The toys, floors, desks and other equipment and surfaces were clean, toxic free, safe and in good condition. There is a water service dispenser indoors and for drinking outside of the water is in water jugs and children use their individually marked cups for drinking. The children's restrooms and changing table were inspected and were found to be clean and sanitary. A current menu was posted in at the least each classroom. Food prep areas are clean. Food is properly stored and free of contamination. Garbage cans containing solid waste have tight fitting lids. The playground was free of hazards. The playground equipment and surface areas were in safe condition. There is adequate cushioning underneath climbing structures and/or play equipment to absorb falls. There were no bodies of water observed. Director Williams stated no weapons are stored on site and none were observed. During today's inspection, staffing ratios were being met and there were a total of 29 children being supervised by six teachers/aides. The facility was operating within the licensed capacity. At least one staff member present during the visit possessed current CPR and First Aid certifications. Seven children’s records were reviewed, and contained identification forms with authorized representative information, as well as medical assessments. Three staff records were reviewed, and contained health screening forms as well as other required items. The review of children's and staff files were in compliance. The sign in/out procedure was reviewed and in compliance.

This facility is providing Incidental Medical Services (IMS) to children. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Continued on next page...
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David WilsonTELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
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
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: TEHAMA CENTER
FACILITY NUMBER: 521370103
VISIT DATE: 10/23/2019
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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: www.ada.gov/childqanda.htm.

This report was reviewed and discussed with Director Trisha Williams.

All licensing reports are public information and must be made available upon request for at least three years.

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: David WilsonTELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2019
LIC809 (FAS) - (06/04)
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