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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045408429
Report Date: 03/25/2024
Date Signed: 03/25/2024 04:23:11 PM

Document Has Been Signed on 03/25/2024 04:23 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:BUSY BABIES DAYCARE & PRESCHOOL ROOM 2FACILITY NUMBER:
045408429
ADMINISTRATOR:CARPENTER, HEATHERFACILITY TYPE:
860
ADDRESS:2115 MYERS ST.TELEPHONE:
(530) 990-5566
CITY:OROVILLESTATE: CAZIP CODE:
95966
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 0DATE:
03/25/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Hearther Carpenter TIME COMPLETED:
03:00 PM
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 Licensing Program Analyst (LPA) Snow met with applicant, Heather Carpenter ON 3/25/24 regarding a new application to cater for 24 preschool children.

OFFICE MEETING AT 520 COHASSET RD170 CHICO TO DISCUSS THE FOLLOWING DOCUMENTS THAT ARE MISSING OR REQUIRE CORRECTIONS:
A7. Balance Sheet (LIC 403) [101169(c)(15), 101213]
(Not required for a public agency)
a. Figures are realistic, e.g., surrender value and not face value of life insurance, appraised value of real estate include
b. Funds/assets are readily available.
c. Ensure the LIC 403 has both the name of preparer & original signature(s) of applicant(s).
A8. Financial Information Release & Verification (LIC 404) [101213]
Submit bank statements in the name of the LLC to show you have operating costs.
A12. Emergency Care and Disaster Plan (LIC 610) [101174]
b. Includes two temporary relocation sites away from the facility that can accommodate the number of children in the facility. Best practice: get written permission from the relocating site.
A13. Earthquake Preparedness Checklist (EPC) (LIC 9148) H&S [1596.867 ] The EPC is primarily an educational tool and is not a requirement for obtaining or keeping a license. However, a copy of this form must be attached to the Emergency Disaster Plan (LIC 610)
A14. Facility Sketch (floor plot plans- LIC 999 or 8½ x 11 sheet) 101173(b)(7) continued
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2024
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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: BUSY BABIES DAYCARE & PRESCHOOL ROOM 2
FACILITY NUMBER: 045408429
VISIT DATE: 03/25/2024
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a. Indoor sketch. Each room used for care must indicate the component, dimensions & room number, or name. Identify the following: infant nap area, staff bathroom, food prep, isolation area, staff bathroom, number and location of toilets and sinks. Identify what the unlicensed areas are used for.
b. Outdoor sketch indicates the component, shows dimensions, driveways, buildings, fences, storage areas, climbing structures, pools, play areas, gardens, etc.
c. Birdseye view shows the entire property/building including parking/street/entry. and the relationship between the indoor and outdoor space of all components, as well as any other uses of the buildings.

B1. Partnership Agreement, Articles of Incorporation, or Articles of Organization
i. Operating Agreement, All LLCs must have an operating agreement. Operating specify who will manage the business, who the owners are, how decisions will be made and much more.
ii. Names, titles, business addresses and phone numbers to all managing members, managers, and non-managing members holding a 10 percent or more interest in the LLC
B2. Verification of Director Qualifications, Transcripts, Verification of Experience Letters (LIC 9096) [10215.1, 10145, 10515]
b. Orientation Training [101169(b)]
B3. Job Descriptions [101173(b)(5), 101217]
a. All positions (relating to ratio/no need to list office staff)
Position name matching the LIC500
Line of Supervision (who this person reports to)
Duties & Responsibilities
Minimum Qualifications:
Driver's license number if the employee is to transport children. Educational background, training and/or experience
Employee Rights (LIC 9052 [3/03]).
A health screening as specified in Section 101216(g).
Tuberculosis test documents as specified in Section 101216(g).
Criminal record clearance or a criminal record exemption
CCLD required checks: FBI,DOJ, CACI
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: BUSY BABIES DAYCARE & PRESCHOOL ROOM 2
FACILITY NUMBER: 045408429
VISIT DATE: 03/25/2024
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 B4. Personnel Policies [101173(b)(5), 101216, 101169(c), 101170]
a. Work hours and shifts included
b. Employee rights included
c. Facility’s abuse reporting procedures and Mandated Reporter Training
d. Hiring practices and conditions of employment included
B5. In-Service Training Plan [101173(b)(6), 101216(e)]
a. Indicates what staff will receive training.
b. Indicates who will give the training
c. Indicates the topics to be covered:
i. Principles of nutrition, food preparation and storage, and menu planning.
ii. Housekeeping and sanitation principles, including universal health precautions.
iii. Provision of child care and supervision, including communication
iv. Assistance with prescribed medications that are self-administered.
v. Recognition of early signs of illness and the need for professional assistance.
vi. Availability of community services and resources.
B6. Parent Handbook/Program Description/Admission Policies & Procedures/Discipline Policies [101169(a)-(f), 101218, 101218.1]
Child Care Program Description

• Category and age of children accepted for care
• Supplementary services
• Transportation arrangements
• Provisions for infant safe sleep (infants only) to include infant napping log, LIC

• Needs and Services Plans & who provides milk (infants only)
• Criteria for determining appropriate placement given child’s needs (parent interviews, pre-admission appraisal, etc.)
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
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
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: BUSY BABIES DAYCARE & PRESCHOOL ROOM 2
FACILITY NUMBER: 045408429
VISIT DATE: 03/25/2024
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Discipline Policies
• Types of discipline not permitted included. No Corporal Punishment/Violation of
Personal Rights.
• Provisions for contacts/conferences with parents included
• Grounds for dismissal/removal included (i.e. the parent will be contacted, behavior will be documented, teacher and parent conferences will be held to discuss behavior, a plan will be in place to help the behavior)
B8. Admission Agreement [101173(b)(3), 101219]
This must be a standalone document (not just a signature line at the end of the handbook)
h. Toddler option statement included (written permission from the authorized representative is required).
B10. List of Furniture & Play Equipment [101239, 101239.1, 101439, 101439.1]
List for each separate component:
a. Number of tables and chairs included
b. Cots and mats for each child included
c. Cribs for infant included
d. Toys and equipment are safe and age appropriate
B14. Background Clearances [101169(c), 101170]
a. Date of background clearance eligibility for:
a. Applicant/icensee Representative Required Documents:
a. Immunizations (SB 792) FLU decline needed for Megan
d. Application Orientation Certificate application part needed for Megan
e. Operations and Record Keeping Orientation Certificate needed for Megan
f. Megan needs to associate her clearance
Waiver:
Need to request one to share the play yards between licensed programs
Need to request one for Heather to be center director at 2 addresses.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2024
LIC809 (FAS) - (06/04)
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