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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525405800
Report Date: 09/09/2020
Date Signed: 09/09/2020 12:23:05 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:LITTLE FRIENDS OF CAPAYFACILITY NUMBER:
525405800
ADMINISTRATOR:BROWN, TONIFACILITY TYPE:
850
ADDRESS:25490 MOLLER AVENUETELEPHONE:
(530) 865-2806
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY:24CENSUS: 13DATE:
09/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Toni Brown, DirectorTIME COMPLETED:
11:45 AM
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The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak by Licensing Program Analyst (LPA) Sandy Husband in response to an application to add room #6 while keeping the current capacity of 24. This program is operated by Capay Friends Community Church as a private program on the Capay Friends Community Church campus. Operating hours are 7:30 AM to 4:00 PM, Monday - Friday. The facility was toured inside and outside and the floor and yard plan were verified. Room #6 was measured for a capacity of 5 preschoolers. Water is provided indoors via a water fountain. Pitchers of water with individual cups are provided in the outdoor play area. The facility has a first aid kit on site. Medications are locked in the first aid bag. The facility has a fire extinguisher rated at least the 2A10BC and there is a working carbon monoxide detector and fire alarm on site. The Director has proof of current CPR/First Aid which expires on 3/21; a Mandated Reporter certificate, which expires 8/31/22, and a completed Preventive Health Practices which includes the nutrition course. The fire clearance was approved for 5 preschoolers in room #6 on 8/25//20. The indoor capacity measured for 50 preschoolers and previous outdoor capacity measured for 24 preschoolers. Therefore, the room addition to accommodate 5 children is granted with a total capacity remaining at 24.

This report was reviewed and discussed with the Director. 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: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2020
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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