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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407679
Report Date: 08/06/2021
Date Signed: 08/06/2021 09:16:43 AM

Document Has Been Signed on 08/06/2021 09:16 AM - 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:TUCKER, WIND FAMILY CHILD CARE HOMEFACILITY NUMBER:
045407679
ADMINISTRATOR:TUCKER, WINDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 249-6368
CITY:OROVILLESTATE: CAZIP CODE:
95966
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
08/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Raven TuckerTIME COMPLETED:
09:20 AM
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On 8/6/21 at 8:30am, an annual required inspection was made to the facility by Licensing Program Analyst (LPA), Emilia Grisak. A review of staff records on 8/6/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently two adults living in the home.

At 8:30am the home was toured inside and outside. The licensee and one assistant were supervising 7 children, and operating within the licensed capacity and ratio requirements. The facility’s normal operating hours are 6am - 6pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the entire upstairs, three downstairs bedrooms linen closet, laundry room and kitchen, and were made inaccessible by door knob covers and baby gates. Poisons are locked in an outdoor shed that is inaccessible. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. The fireplace is not being used and has furniture blocking access. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's inspection. The home is clean, orderly and comfortable. Stairs are fenced with baby gates. There are safe toys and equipment available for children. There is a working telephone in the home.

There are cribs/play yards available for napping infants. Cribs have firm mattresses and are free of loose objects. Bedding is laundered daily, and soiled bedding is stored inaccessible to infants. Napping infants are checked on every 15 minutes, and checks are documented on licensee's cell phone and written documentation will also be added to the file. No infants were observed to be swaddled, and infants under 12 months are placed on their backs for sleeping.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2021
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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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: TUCKER, WIND FAMILY CHILD CARE HOME
FACILITY NUMBER: 045407679
VISIT DATE: 08/06/2021
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The children use the front yard as the outdoor play area and it is not fully fenced and licensee is aware that constant visual supervision must be provided when children are outside. The backyard is currently off-limits while work is being done, but will eventually be used for children in care and it is fully fenced. There were no pools or other bodies of water observed in the yard.

Three children's records were reviewed at 9:00am; required emergency information forms were observed to be on file. There are currently no infants enrolled under 12 months but licensee is aware that Individual Sleeping Plans must be on file for infants under 12 months. The licensee has completed Mandated Reporter training. The licensee and all employees have the required immunizations on file. The licensee has current pediatric CPR and First Aid certification, which expire on 1/29/22.

This report was reviewed and discussed with the licensee. 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.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC809 (FAS) - (06/04)
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