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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125406692
Report Date: 06/05/2024
Date Signed: 06/05/2024 02:01:44 PM

Document Has Been Signed on 06/05/2024 02:01 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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:LOCKETT, MICHELLE FAMILY CHILD CARE HOMEFACILITY NUMBER:
125406692
ADMINISTRATOR/
DIRECTOR:		LOCKETT, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 441-1712
CITY:EUREKASTATE: CAZIP CODE:
95503
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 1DATE:
06/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Michelle LockettTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
NARRATIVE
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Licensing Program Analysts (LPA) Kiriko Lynch and Noah Wheeler were at the home for an unrelated visit when LPA Lynch observed hot tub cover was unsecured in three out of four locks. LPA asked Licensee to secure hot tub cover locks on hot tub, and Licensee did immediately. LPA also observed a shallow pool of water at the bottom of the hot tub. Licensee stated children are not currently using the backyard due to dog holes, and LPAs did not observe any children in the backyard at the time of the visit. LPAs also observed multiple items on top of hot tub cover weighing cover down, and was not easily opened by LPA or Licensee due to items on top. Title 22 regulations is being cited on LIC 809-D.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2024
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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Document Has Been Signed on 06/05/2024 02:01 PM - It Cannot Be Edited


Created By: Kiriko Lynch On 06/05/2024 at 01:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: LOCKETT, MICHELLE FAMILY CHILD CARE HOME
FACILITY NUMBER: 125406692

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/06/2024
Section Cited
CCR
102417(5)(A)

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(5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A) ... Pool covers shall be strong enough to completely
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LPA observed Licensee fixed locks during visit and stated she will ensure hot tub stays locked during day care hours of operation. POC cleared during visit.
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support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.
This requirement was not met as evidenced by three of four hot tub cover locks were not locked on hot tub. Hot tub had many items on top and also a shallow amount of water.
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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:Erin Virrueta
LICENSING EVALUATOR NAME:Kiriko Lynch
LICENSING EVALUATOR SIGNATURE:
DATE: 06/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2024


LIC809 (FAS) - (06/04)
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