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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525407624
Report Date: 10/21/2020
Date Signed: 10/21/2020 11:27:20 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:QUESADA, THOMASINA FAMILY CHILD CARE HOMEFACILITY NUMBER:
525407624
ADMINISTRATOR:QUESADA, THOMASINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 364-1084
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:14CENSUS: 7DATE:
10/21/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Thomasina QuesadaTIME COMPLETED:
11:00 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), Wisehart. A Case Management visit was conducted, facility toured and interview conducted.

The LPA discussed with the licensee concerns about getting into a CPR/First Aid class due to COVID -19. The LPA observed that the licensee has a current CPR/First Aid card which expires 11/17/20 and she was able to get into a CPR/First Aid class scheduled on Nov 7th, 2020.

The Licensee and LPA also discussed immunization's and the LPA clarified which immunization's are required and which ones can be declined, with a written statement on file.

An exit interview was conducted and no deficiencies were sited during todays visit.

The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020
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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