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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585407898
Report Date: 03/07/2024
Date Signed: 03/07/2024 10:56:42 AM

Document Has Been Signed on 03/07/2024 10:56 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:PACKARD, NATASHA FAMILY CHILD CARE HOMEFACILITY NUMBER:
585407898
ADMINISTRATOR:PACKARD, NATASHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(971) 235-3601
CITY:MARYSVILLESTATE: CAZIP CODE:
95901
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
03/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Natasha Packard - Licensee TIME COMPLETED:
11:06 AM
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An unannounced case management inspection was conducted today 3/7/24 at 10:30am by Licensing Program Analysts (LPA), S. Sims and T. Dutra. LPAs met with licensee Natasha Packard. In response to an Unusual Incident Report received by the Department on 3/4/24.

The licensee was interviewed on 3/7/24 at 10:40am and stated that on 3/1/24 Licensee was in the kitchen and had supervision of C1. C1 began running into the entry hall way while Licensee was in the Kitchen. Licensee told C1 to not run inside, during this time C1 tripped and fell over a toy and hit their head on a cubby. Licensee provided immediate care with warm wash rag and contacted parents for pick up.

No staff or children were interviewed because Licensee was the only one present for the incident and children were not capable of being interviewed due to their age.

During today’s inspection, the facility was toured and UIR report was reviewed.
LPA observed 8 children in care, being supervised by Licensee and assistant.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Sydney Sims
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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: PACKARD, NATASHA FAMILY CHILD CARE HOME
FACILITY NUMBER: 585407898
VISIT DATE: 03/07/2024
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Based on Information reported and interviews conducted, LPA Sims and Dutra Determined the incident could not have been prevented.

Exit interview conducted and report was reviewed with the licensee Natasha Packard. Appeal Rights were provided.

There were no deficiencies cited during today’s inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Sydney Sims
LICENSING EVALUATOR SIGNATURE:

DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024
LIC809 (FAS) - (06/04)
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