475404269-10-3-2022-13-CC-NCUM-CJUTMD-20221003145057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 475404269
Report Date: 09/22/2022
Date Signed: 10/03/2022 02:51:12 PM

Document Has Been Signed on 10/03/2022 02:51 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:	MCCLOUD ELEMENTARY PRESCHOOL		FACILITY NUMBER:	475404269
ADMINISTRATOR:	RAMOS, AMBER		FACILITY TYPE:	850
ADDRESS:	332 HAMILTON WAY		TELEPHONE:	(530) 964-2133
CITY:	MCCLOUD	STATE: CA	ZIP CODE:	96057
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 10	CENSUS: 0	DATE:	09/22/2022
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Amber Ramos		TIME COMPLETED:	01:30 PM

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On 09/22/22 at 10:30am, an annual\ inspection was made to the facility by Licensing Program Analyst (LPA), N. Cunningham. The program operates mid August - mid June, Monday–Friday, 8:00 - 11:30pm. This program is operated by Siskiyou Child Care Council, Inc. and is a Title 5 funded program.

Site Supervisor was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Ten children's records were reviewed at 12:30pm. Two staff records were reviewed at 1:00pm.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MCCLOUD ELEMENTARY PRESCHOOL	FACILITY NUMBER: 475404269
	VISIT DATE: 09/22/2022

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There were no deficiencies cited during today’s inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Ramos.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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