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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 485408322
Report Date: 08/11/2023
Date Signed: 08/11/2023 10:44:42 AM

Document Has Been Signed on 08/11/2023 10:44 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:SHELLEY DALLY EARLY LEARNING VILLAGE HOUSE CCCFACILITY NUMBER:
485408322
ADMINISTRATOR:HYLTON, LAURENFACILITY TYPE:
850
ADDRESS:500 AZALEA WAYTELEPHONE:
(707) 453-6148
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 46TOTAL ENROLLED CHILDREN: 46CENSUS: 0DATE:
08/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Korina NevarezTIME COMPLETED:
10:50 AM
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A prelicensing inspection was conducted today at 9:30 AM by Licensing Program Analyst (LPA), J. Helton. LPA met with facility representative Korina Nevarez. The applicant is requesting a license for preschool age children, with a capacity of 46. The facility will operate Monday-Friday, 8:15 AM to 11:15 AM, 12:00 PM to 3:00 PM. The facility has 3 classrooms and 2 bathrooms for children. Staff use the center next door that is connected for bathrooms.
The indoor and outdoor activity spaces were toured, and the facility sketch was verified. The following areas will be off limits to children office only, however if needed for isolation a child can stay in there with supervision. These areas have been made inaccessible by means of supervision. There is a kitchen at the connected center to prepare meals that will be brought over. There is a no nap room. The isolation area for sick children will be located in the nurses station.

The outdoor play area is fully fenced. There is climbing play structure for children to play on and adequate cushioning underneath. The children will be escorted over to the main center's playground. There is no pool, spa, pond, fountain, or any other body of water on the premises. There are no poisons on premises. There is safe and age appropriate furniture, toys, and play equipment available for children.

A capacity worksheet was completed during the visit. There is enough indoor space for 42 children and outdoor space for 147 children. There are 4 toilets and 4 sinks available for children. Based on the above, the maximum capacity of the facility could be 42.

Facility representative was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2023
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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: SHELLEY DALLY EARLY LEARNING VILLAGE HOUSE CCC
FACILITY NUMBER: 485408322
VISIT DATE: 08/11/2023
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) tollfree ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA reviewed with facility representative the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed facility representative 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.

Applicant, was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the facility representative Korina Nevarez.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC809 (FAS) - (06/04)
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