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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585408421
Report Date: 07/25/2024
Date Signed: 07/25/2024 09:48:16 AM

Document Has Been Signed on 07/25/2024 09:48 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:WASHINGTON, NICOLE FAMILY CHILD CARE HOMEFACILITY NUMBER:
585408421
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
07/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:21 AM
MET WITH:Nicole WashingtonTIME VISIT/
INSPECTION COMPLETED:
09:55 AM
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On 7/25/24 at 9:21am Licensing Program Analyst (LPA), Tammy Dutra conducted a case management facility inspection. This inspection was in response to an application for increased capacity that was received by the Department on 6/17/24. The licensee has requested a capacity increase to 14 children.

The LPA toured the facility's indoor and outdoor areas of the home. The off-limits areas of the home are the entire main part of the home and the laundry room in the in law unit and is kept off limits using door locks and baby gate. There were no pools or other bodies of water observed in the yard. The licensee was supervising three children at the time of the visit, and was operating within capacity. The LPA reviewed the ratio's for a large license and the licensee acknowledged she understood the ratio requirements. The LPA also reviewed the Safe Sleep requirements with provider.



Licensee's CPR/First Aid was completed and exp on 4/25. Based on the space/accommodations available at this facility and the fire marshal granting their approval on 7/1/24 for the 14 children, the capacity increase request is granted. LPA will process this capacity increase and mail an updated license to reflect this capacity change to 14 children. An exit interview was conducted with licensee Nicole Washington.

Notice of Site Visit was given to licensee to post for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
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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