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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125406166
Report Date: 04/29/2025
Date Signed: 04/29/2025 01:45:20 PM

Document Has Been Signed on 04/29/2025 01:45 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:YUROK TRIBE EARLY CHILDHOOD EDUCATION CTR.FACILITY NUMBER:
125406166
ADMINISTRATOR/
DIRECTOR:		JIMENEZ, AUTUMNFACILITY TYPE:
850
ADDRESS:3400 ERIE STREETTELEPHONE:
(707) 444-0433
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY: 75TOTAL ENROLLED CHILDREN: 35CENSUS: 33DATE:
04/29/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Jesika SheafTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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An unannounced case management inspection was conducted today at 11:30 p.m. by Licensing Program Analysts (LPA) Noah Wheeler and Kiriko Lynch. LPAs met with facility representative Jesika Sheaf. In response to an Unusual Incident Report from 02/02/2025. Facility representative stated the ECE classroom was transitioning from outside to inside and the staff miscounted during transition. She stated an aide (S3) noticed one child (C1) was missing and S3 immediately called for C1 and found C1 sleeping in a pop-up play tent in the playground area.

The facility representative was interviewed on 04/29/2025, and she stated that on 02/20/2025 at approximately 11:35 a.m., C1 was left outside in the exterior fenced playground area for approximately 2 to 3 minutes while the class was transitioning from outside to inside for lunch. She stated staff miscounted when transitioning because of a staff attending to another child who was being changed in the bathroom at the same time. She stated teachers S1 and S2 were on site and reported the incident when it occurred.

Continued on 809-C
NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Noah Wheeler
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 04/29/2025 01:45 PM - It Cannot Be Edited


Created By: Noah Wheeler On 04/29/2025 at 12:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: YUROK TRIBE EARLY CHILDHOOD EDUCATION CTR.
FACILITY NUMBER: 125406166

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2025
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs.
(1) No child(ren) shall be left without the supervision of a teacher at any time. except as specified in Sections 101216.2(e)(1)...
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Faciltiy representative stated that facility had a staff meeting and went over supervision policies and best practices. Facility represenattive submitted written proof of correction during visit. POC cleared at time of visit.
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 and 101230(c)(1). Supervision shall include visual observation. This requirement was not met evidenced by interviews and records review. C1 was left outside fro approximately 2-3 minutes during transition which poses a possible risk to the health, safety, or personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Erin Virrueta
NAME OF LICENSING PROGRAM MANAGER:
Noah Wheeler
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 04/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2025


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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: YUROK TRIBE EARLY CHILDHOOD EDUCATION CTR.
FACILITY NUMBER: 125406166
VISIT DATE: 04/29/2025
NARRATIVE
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Three staff (S1-S3) were interviewed on 04/29/2025, and stated C1 was left in playground for approximately 2 to 3 minutes during transition from outside to inside before lunch at 11:35 a.m. Staff stated C1 was found in a pop-up tent outside in the playground area where C1 was taking a nap. Staff stated C1 woke up happy and was in a good mood for lunch. Staff stated they did not properly count during transition as there was confusion because of another child being changed in the bathroom.

During today’s inspection, the facility was toured and LPAs observed care and supervision to children provided by staff to children in care. LPAs observed outside playground is completely fenced with a latched lockable gate. LPAs found the staff interviews corroborated the written Unusual Incident Report that was initially submitted to Licensing.

Based on interviews and record review, LPAs found staff failed to conduct accurate head counts when transitioning from outside to inside, and also failed to check the playground for children who may have been hiding or sleeping, and the following deficiency is being cited on the LIC809-D.

Exit interview conducted and report was reviewed with the facility representative Jesika Sheaf and Appeal Rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Erin Virrueta
NAME OF LICENSING PROGRAM ANALYST: Noah Wheeler
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
LIC809 (FAS) - (06/04)
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