<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 581376456
Report Date: 05/14/2024
Date Signed: 05/14/2024 03:32:07 PM


Document Has Been Signed on 05/14/2024 03:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:YUBA COLLEGE CHILD CARE CENTERFACILITY NUMBER:
581376456
ADMINISTRATOR:STANIS, KARENFACILITY TYPE:
850
ADDRESS:2088 NORTH BEALE ROADTELEPHONE:
(530) 634-7741
CITY:MARYSVILLESTATE: CAZIP CODE:
95901
CAPACITY:87CENSUS: DATE:
05/14/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:39 PM
MET WITH:Renee McKenzieTIME COMPLETED:
03:41 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An unannounced case management inspection was conducted today at 2:39 pm by Licensing Program Analyst (LPA), Tammy Dutra. LPA met with facility representative, Renee McKenzie. In response to an Unusual Incident Report received by the Department on 4/16/24.

The facility representative was interviewed on 5/14/24 at 2:39 am and stated that on 4/16/24 at 10:40am C1 was climbing over a bar and slipped and hit the left side of their face causing a nose bleed and swollen nose. C1 was taken to get medical attention and it was established there was a fracture on the tip of the nasal bone.

Three staff were interviewed on 5/14/24 and one parent on 5/13/24 stated that C1 was playing on the fire truck structure in an appropriate manner and did think the accident was avoidable. There was appropriate staffing during the incident and the child was playing on the equipment in an appropriate manner.

During today’s inspection, the facility was toured.LPA observed the play equipment and established it is appropriate for the age group of children in care.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Tammy DutraTELEPHONE: (530) 806-3471
LICENSING EVALUATOR SIGNATURE:
DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/14/2024
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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: YUBA COLLEGE CHILD CARE CENTER
FACILITY NUMBER: 581376456
VISIT DATE: 05/14/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the interviews and facility tour, LPA determined the incident was an accident and there was nothing staff could have done to prevent the injury from occuring.

There were no deficiencies cited during today’s inspection. Exit interview conducted and report was reviewed with the facility representative, Renee McKenzie . Appeal Rights were provided. A notice off site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Tammy DutraTELEPHONE: (530) 806-3471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2