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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115408177
Report Date: 09/22/2022
Date Signed: 09/22/2022 09:45:20 AM

Document Has Been Signed on 09/22/2022 09:45 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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:COLEMAN, MADELEINE FAMILY CHILD CARE HOMEFACILITY NUMBER:
115408177
ADMINISTRATOR:COLEMAN, MADELEINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 774-7078
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/22/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Madeleine ColemanTIME COMPLETED:
09:55 AM
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A prelicensing inspection was conducted today by Licensing Program Analyst (LPA), Emilia Grisak in response to a change of location application that was received by the Department on 8/10/22. LPA met with licensee Madeleine Coleman. The licensee is requesting a license for a capacity of 14. A fire clearance was granted on 9/19/22 for a capacity of 14. The facility will operate Monday-Friday, 7am to 5:30pm. The residence is a three bedroom/two bath single story home. There are three adults and two minors currently living on the property.

The home and yard were toured, and the facility sketch was verified. The following areas will be off limits to children: one bedroom and bathroom and all outdoor sheds and structures. These areas have been made inaccessible by means of door knob covers and door locks. There were no poisons present and licensee was advised they must be locked if present. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. The fireplace is securely screened. The applicant is in the process of installing a fenced in play area for children to use. The outdoor area will be inaccessible to children until the fenced in outdoor play area is completed. There is no pool, spa, pond, fountain, or any other body of water on the premises.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE: DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/22/2022
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: COLEMAN, MADELEINE FAMILY CHILD CARE HOME
FACILITY NUMBER: 115408177
VISIT DATE: 09/22/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The facility is ready to be licensed.

Exit interview conducted and report was reviewed with the applicant Madeleine Coleman.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Emilia Grisak
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022
LIC809 (FAS) - (06/04)
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