581374037-5-29-2024-13-CC-TDUA-D5QNNL-20240529103654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 581374037
Report Date: 05/29/2024
Date Signed: 05/29/2024 10:37:01 AM

Document Has Been Signed on 05/29/2024 10:37 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	DOBBINS PRESCHOOL		FACILITY NUMBER:	581374037
ADMINISTRATOR/ DIRECTOR:	CRITCHFIELD, JOLIE		FACILITY TYPE:	850
ADDRESS:	1 DOBBINS SCHOOL LN		TELEPHONE:	(530) 692-1665
CITY:	DOBBINS	STATE: CA	ZIP CODE:	95935
CAPACITY: 26	TOTAL ENROLLED CHILDREN: 26	CENSUS: 12	DATE:	05/29/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:22 AM
MET WITH:	Roxann Galloway		TIME VISIT/ INSPECTION COMPLETED:	10:43 AM

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On 5/29/24 at 8:22am, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Tammy Dutra. This program is operated by a public agency and a Title 5 funded program. Operating hours are 8:00am-11:00am, Monday–Friday. The facility was toured at 8:47am inside and outside and the floor and yard plan submitted by the licensee were verified. Facility operates in the preschool room on Dobbins Elementary School campus.

The facility representative and two para educators were supervising 12 children, and operating within the licensed capacity and ratio requirements. There are no pools or bodies of water on the premises. The outdoor activity space was cushioned with wood chips and is free of hazards.

Five children's records were reviewed at 9:08am. Three staff records were reviewed at 9:25am.

No deficiencies were cited on today's visit.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: DOBBINS PRESCHOOL	FACILITY NUMBER: 581374037
	VISIT DATE: 05/29/2024

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

CCC has a waiver on file for their lead testing. Facility does not prepare food on site and only uses bottled water for drinking water at this site.

LPA referred facility representative to the Department website for lead:

https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: DOBBINS PRESCHOOL	FACILITY NUMBER: 581374037
	VISIT DATE: 05/29/2024

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing 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: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative Roxann Galloway.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2024

LIC809 (FAS) - (06/04)

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