<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045408033
Report Date: 11/16/2023
Date Signed: 11/16/2023 03:12:19 PM

Document Has Been Signed on 11/16/2023 03:12 PM - 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:TIPTON, JENNIFER FAMILY CHILD CARE HOMEFACILITY NUMBER:
045408033
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
11/16/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:48 PM
MET WITH:Jennifer TiptonTIME COMPLETED:
03:21 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA), Mendez conducted a case management facility inspection on 11/16/23 at 2:48 PM. This inspection was in response to an application for increased capacity. The application was received by the Department on 09/06/23. The licensee requested a capacity increase to 14 children.

LPA toured the facility's indoor and outdoor areas. The off limits areas of the home are, laundry room, and all bedrooms are made inaccessible by door knob covers. The children use the back yard as the outdoor play area, and it is fenced. There were no pools or other bodies of water observed in the yard. The LPA reviewed the staff ratio 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 expires 01/08/2024

Local fire authority approved fire clearance on 11/13/2023.

As of today’s date, 11/16/2023, the capacity increase request is granted. An exit interview was conducted with licensee.

SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1