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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 511306431
Report Date: 10/13/2021
Date Signed: 10/13/2021 10:34:00 AM

Document Has Been Signed on 10/13/2021 10:34 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:YUBA CITY CHILDREN'S CENTERFACILITY NUMBER:
511306431
ADMINISTRATOR:SANDERS, TAMIFACILITY TYPE:
850
ADDRESS:445 BERNARD DRIVETELEPHONE:
(530) 822-5235
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 41DATE:
10/13/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Fawn UeberschaerTIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Martinez conduced a follow-up visit at the Yuba City Children's Center and met with Site Supervisor Fawn Ueberschaer. There was a self reported Incident Report called into the Department on 6/22/21 from the Site Supervisor to LPA Martinez. Interviews and a facility visit was conducted by Investigator C. Krogstad. The incident was reported to Community Care Licensing as required. At this time, with the information available, it is determined that no violation of regulations resulted from the alleged incident. This report was reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request.
Notice of Site Visit shall be posted for 30 days from today's inspection.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Mikah Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2021
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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