Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045404706
Report Date: 08/16/2018
Date Signed 08/16/2018 04:15:29 PM

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:WILLIAMS, MELISSA FAMILY CHILD CARE HOMEFACILITY NUMBER:
045404706
ADMINISTRATOR:WILLIAMS, MELISSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 342-6676
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:14CENSUS: 11DATE:
08/16/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Melissa Williams, DirectorTIME COMPLETED:
04:20 PM
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An unannounced annual inspection was made to the facility by LPA, Sandy Husband. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are presently 2 adults living in the home.

During today’s inspection the home and grounds were toured. The licensee's two assistants were properly supervising children during outdoor play while the licensee picked up daycare children from school. The family child care home was operating within the licensed capacity and ratio requirements with 11 children total consisting of 5 school-agers, 1 infant and 5 preschool age children. No children were observed left in any parked vehicle. Operating hours are 6 AM to 5:30 PM, Mon–Fri. The floor plan was verified. The off-limits areas included the master bedroom, Bedroom #2, and the shop which were inaccessible. The home appeared clean and orderly and was at a comfortable indoor temperature of 77 degrees. There is a working telephone in the home. The licensee's pediatric CPR and First Aid expire 2/22/19. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. Poisons are locked in the adjacent shop. The fireplace has a secured screen. There is a working smoke detector, carbon monoxide detector and charged fire extinguisher, rated at least 2A10BC, in the home. The licensee has a current roster of children in care and has conducted an emergency drill within the past six months on 8/3/18. Weapons and ammunition are locked separately. The children use the backyard as the outdoor play area and it is fully fenced. There is a pool in the back yard. The pool is fully fenced with wood slats and meets Title 22 regulations with a self-closing, self-latching gate. Mandated reporter training was completed by staff on 1/16/18. Eleven children's records and 3 staff records were reviewed and found to be in substantial compliance. The licensee is not providing Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a
(Continued on LIC 809-C)
SUPERVISOR'S NAME: Erin McKayTELEPHONE: (530) 895-2660
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2018
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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: WILLIAMS, MELISSA FAMILY CHILD CARE HOME
FACILITY NUMBER: 045404706
VISIT DATE: 08/16/2018
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(Continued from LIC 809)
Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice 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,www.ada.gov/childqanda.htm. This report, as well as the AAP Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.

SUPERVISOR'S NAME: Erin McKayTELEPHONE: (530) 895-2660
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2018
LIC809 (FAS) - (06/04)
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