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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485408032
Report Date: 03/18/2022
Date Signed: 03/18/2022 12:14:51 PM

Document Has Been Signed on 03/18/2022 12:14 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:AUGUST, LINDA FAMILY CHILD CARE HOMEFACILITY NUMBER:
485408032
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/18/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Applicant, Linda AugustTIME COMPLETED:
12:30 PM
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A prelicensing inspection was conducted today at 10:00am by Licensing Program Analyst (LPA), Kirk Marks. LPA met with applicant Linda August. The applicant is requesting a license for a capacity of 8. The facility will operate Monday-Friday, 8:00am to 6:00pm. The residence is a 4 bedroom/3 bath single story home. There are five adults and four minors (foster children) 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 four bedrooms, two bathrooms and the garage. These areas have been made inaccessible by means of locking child gate and locks. Poisons are locked in a cabinet in laundry area. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. The fireplace will be securely screened with child proof gate. The children will use the backyard and front yard as the outdoor play areas. Both yards are completely fenced. There is an in ground pool on the property which is fenced by five foot metal grate fencing with a self latching gate that swings away from the pool.
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.

Applicant was 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.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Kirk Marks
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2022
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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