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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475408358
Report Date: 10/05/2023
Date Signed: 10/09/2023 08:25:53 AM

Document Has Been Signed on 10/09/2023 08:25 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:KINCADE, ALIZA & CAROLYN FAMILY CHILD CARE HOMEFACILITY NUMBER:
475408358
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
10/05/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Aliza and Carolyn KincadeTIME COMPLETED:
12:45 PM
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A prelicensing inspection was conducted today at 10:45 am by Licensing Program Analyst (LPA), Cunningham. LPA met with applicant Aliza and Carolyn Kincade. The applicant is requesting a license for a capacity of 8. The facility will operate Monday-Friday, 7:00 am to 5:00 pm. The residence is a 3 bedroom/2 bath single story home. There are 3 adults and 7 minors currently living in the home.

The home and yard were toured, and the facility sketch was verified. The following areas will be off limits to children: all bedrooms and master bathroom.

These areas will be made inaccessible by means of door locks. The applicants states no Poisons are located on site. The home is equipped with a working smoke detector. The children will use the backyard as the outdoor play area. The backyard is completely fenced. There is no pool, spa, pond, fountain, or any other body of water on the premises.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted.

Continued on 9099C
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2023
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: KINCADE, ALIZA & CAROLYN FAMILY CHILD CARE HOME
FACILITY NUMBER: 475408358
VISIT DATE: 10/05/2023
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Applicants were reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant/licensee/facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.


Continued on 9099C
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
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: KINCADE, ALIZA & CAROLYN FAMILY CHILD CARE HOME
FACILITY NUMBER: 475408358
VISIT DATE: 10/05/2023
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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The following items need to be completed prior to the granting of license:
1. Fingerprint clearance for household member.
2. Install carbon monoxide detector.
3. Obtain fire extinguisher.
4. Obtain first aid kit.
5. Post required postings.
6. Mop floor and vacuum living room floor.
7. Clean front door.
8. Clean kitchen cabinets.
9. Install child proof locks on kitchen cabinets.
10. TB test for household member.
11. Fill in pot hole on playground and secure swing set.
12. Place child proof latches on bathroom cabinet.
13. Organize bathroom and place cleaning supplies, shampoo, and soap up high.
14. Remove or secure cabinet by front door.

Exit interview conducted and report was reviewed with applicants Aliza and Carolyn Kincade.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC809 (FAS) - (06/04)
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