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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
585407400
Report Date:
10/16/2023
Date Signed:
10/16/2023 01:33:01 PM
Document Has Been Signed on
10/16/2023 01:33 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
CCLD Regional Office
,
520 COHASSET RD., SUITE 170
CHICO
,
CA
95926
FACILITY NAME:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
ADMINISTRATOR:
SILVA, MARICELA
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(530) 830-6733
CITY:
PLUMAS LAKE
STATE:
CA
ZIP CODE:
95961
CAPACITY:
14
CENSUS:
9
DATE:
10/16/2023
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
09:35 AM
MET WITH:
Maricela Silva
TIME COMPLETED:
01:35 PM
NARRATIVE
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On 10/16/2023 at 9:35am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. At 9:50am the home was toured inside and outside. Upon arrival to the home LPA observed the licensee supervising 9 children without an assistant present. The licensee's assistant (A1) arrived at 10:37am.
The facility’s operating hours are 7:30am-5:30pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the garage, laundry room, master bedroom/bathroom, Room #2, and Room #3 as designated on the Facility Sketch, and were made inaccessible by locks and doorknob covers. The children use the back yard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed in the yard.
Nine (9) children's records were reviewed at 10:20am. One staff record was reviewed at 10:50am. There are currently two adults living in the home.
The following deficiencies were cited: CCR 102416.5((e), CCR 102417(g)(9)(A), CCR 102417(g)(8), CCR 102419(d)(1), CCR 102417(m)(3), HSC 1596.8662(b)(1), HSC 1597.622(a)(1)(see LIC 809D's):
SUPERVISOR'S NAME:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
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Document Has Been Signed on
10/16/2023 01:33 PM
- It Cannot Be Edited
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/16/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on an interview, the licensee did not comply with the section cited above. The licensee stated a drill was completed in the summer, however, did not doument the drill as required which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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4
The licensee agrees to provide a copy of her doucmentation of an emergency disaster drill. The plan of correction shall be submitted to CCLD on or before 11/15/2023.
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:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
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Document Has Been Signed on
10/16/2023 01:33 PM
- It Cannot Be Edited
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/16/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on an interview, the licensee did not comply with the section cited above. The licensee's Mandated Reporter Training has expired and her assistant (A1) certificate was not available for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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The licensee agrees to complete and have her assistant complete the MRT as required. The licensee agrees to provide proof of completion to CCLD on or before 11/15/2023.
Type B
Section Cited
CCR
102417(g)(8)
Administration of Child Day Care Licensing
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in the licensee stated that she was unable to locate her updated roster of children in care which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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The licensee agrees to provide a copy of her current Roster of Children in Care. The licensee agrees to submit the plan of correction to CCLD on or before 11/15/2023.
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:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
3
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8
Document Has Been Signed on
10/16/2023 01:33 PM
- It Cannot Be Edited
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/16/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on a record review, the licensee did not comply with the section cited above in one out of one record review indicating that her assistant (A1) proof of measles vaccine was not available for review which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/08/2023
Plan of Correction
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The licensee agrees to provide a copy of A1 proof of measles vaccine. The plan of correction shall be submitted to CCLD on or before 11/1/52023.
Section Cited
Operation of A Family Child Care Home
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
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Document Has Been Signed on
10/16/2023 01:33 PM
- It Cannot Be Edited
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/16/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102419(d)(1)
Admission Procedures and Authorized Representatives Rights
(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). (1) The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or
authorized representative has received and read the LIC 995A. The bottom portion of this form
must be kept in the child’s file as proof that the parent or authorized representative has been
notified of his or her rights and received a copy of the Caregiver background Check Process, LIC
995E (6/05), and the Family Child Care Consumer Awareness Information, LIC 9212 (10/05).
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on a record review, the licensee did not comply with the section cited above in one out of nine children's file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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The licensee agrees to submit a completed Notification of Parent's Rights (LIC995A) for C5 to CCLD on or before 11/15/2023.
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:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
5
of
8
Document Has Been Signed on
10/16/2023 01:33 PM
- It Cannot Be Edited
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
10/16/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(m)(3)
Operation of A Family Child Care Home
(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.
This requirement is not met as evidenced by:
Deficient Practice Statement
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3
4
Based on children's record reviews, the licensee did not comply with the section cited above in 2 out of 9 file reviews which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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The licensee agrees to provide copies of Affidavit Regarding Liability Insurance (LIC 282) for C5 and C6. The plan of correction shall be submitted to CCLD on or before 11/15/2023.
Type B
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
This requirement is not met as evidenced by:
Deficient Practice Statement
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4
Based on LPA's observation, the licensee did not comply with the section cited above. Upon arrival to the home LPA observed the licensee caring to 9 children without an assistant present, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date:
11/15/2023
Plan of Correction
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The licensee agrees to view the video provided on the Departments website (
https://ccld.childcarevideos.org
) regarding staffing and ratios. Once viewed the licensee will submit a written statement on how she will maintain staffing capacity ratios as required. The written statement shall be submitted to CCLD on or before 11/15/2023.
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:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
6
of
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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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
VISIT DATE:
10/16/2023
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to
inspectionprocess@dss.ca.gov
. For additional information regarding the inspection and its tools and methods, please visit the Program website at:
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process
.
Licensee Maricela Silva was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with licensee Maricela Silva and discussed the Child Care Licensing Safe Sleep web page at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep
as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at
https://www.cpsc.gov/
and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
SUPERVISOR'S NAME:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
8
of
8
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:
SILVA, MARICELA FAMILY CHILD CARE HOME
FACILITY NUMBER:
585407400
VISIT DATE:
10/16/2023
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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:
https://www.ada.gov/resources/child-care-centers/
.
Licensee Maricela Silva was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
During the exit interview, Maricela Silva, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Maricela Silva.
SUPERVISOR'S NAME:
Megan Aviles
TELEPHONE:
(530) 895-5984
LICENSING EVALUATOR NAME:
Laura Chavez
TELEPHONE:
(530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE:
10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/16/2023
LIC809
(FAS) - (06/04)
Page:
7
of
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