125406397-7-23-2021-13-CC-JSNW-C57T9D-20210723143143

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 125406397
Report Date: 07/23/2021
Date Signed: 07/23/2021 02:32:02 PM

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:	CHILDREN'S COTTAGE INFANT CENTER		FACILITY NUMBER:	125406397
ADMINISTRATOR:	MCCUTCHEN, ROSE		FACILITY TYPE:	830
ADDRESS:	900 HODGSON STREET		TELEPHONE:	(707) 445-8119
CITY:	EUREKA	STATE: CA	ZIP CODE:	95501
CAPACITY:	28	CENSUS: 4	DATE:	07/23/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Jaquline Luis (Jackie)		TIME COMPLETED:	11:00 AM

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	On 7/22/21 An inspection was made to the facility by Licensing Program Analyst (LPA), Lynch and Snow Jackie Luis. The facility file was reviewed prior to this inspection. A review of the personnel report on 7/12/21. indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The facility’s operating hours are 8-5p Mon-Fri. The facility was toured at 10am time inside and outside and the floor and yard plan submitted by the licensee were verified. Ms. Luis stated no firearms or weapons are stored on site and none were observed. The items which could pose a danger to children (such as disinfectants, cleaning solutions and medications) are inaccessible to children. Poisons are locked in janitor’s closet. Furniture and equipment are in good condition, free of hazards, and age appropriate. The outdoor activity space was cushioned with grass and free of hazards. Toilets and sinks are in sanitary condition and operating properly. The facility floors were clean and safe. The kitchen/food preparation area is clean, and free of litter or rodents. Food is properly stored and free of contamination. Trash cans have tight fitting lids. Drinking water is available to children both inside and outside. The facility was free of flies, insects and rodents. The facility has a working carbon monoxide detector.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime Snow	TELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

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: CHILDREN'S COTTAGE INFANT CENTER	FACILITY NUMBER: 125406397
	VISIT DATE: 07/23/2021

NARRATIVE

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During today's inspection, staffing ratios were being met and there were 4 infants were being supervised by 2 teachers/aides. Infants are not left without visual supervision at any time. The facility was operating within the licensed capacity. At least one staff member present during the visit (S#) possessed current CPR and First Aid certifications. The sign in/out sheet was reviewed, and representatives are using full signatures and recording the time. Staff are provided on-the-job training, including sanitation and universal precautions. Infants with symptoms of illness are not accepted, and children who become ill during the day are isolated in the office.

The facility has a crib or mat/cot for each napping infant. Cribs are free of loose objects. Infants are visually supervised at all times while sleeping, and staff physically check on sleeping infants every 15 minutes. The 15 minute checks are documented on paper and kept in the infant’s file. Infants under 12 months are placed on their backs for sleep, and no infants are swaddled. The LPA discussed the requirement to visually supervise sleeping infants.

Two children’s records were reviewed at 10:2pm, and contained emergency identification forms, medical assessments, and Needs and Services Plans. Infants up to 12 months have an Infant Sleeping Plan on file. No staff records were reviewed because they are located at a different location (Childrens infant and toddler)
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.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaime Snow	TELEPHONE: (530)215-6132
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

LIC809 (FAS) - (06/04)

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