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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585405321
Report Date: 12/02/2022
Date Signed: 12/02/2022 01:39:18 PM

Document Has Been Signed on 12/02/2022 01:39 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:FOSTER, TIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
585405321
ADMINISTRATOR:FOSTER, TIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 741-9609
CITY:PLUMAS LAKESTATE: CAZIP CODE:
95961
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 10DATE:
12/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Tia Foster, LicensingTIME COMPLETED:
01:50 PM
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On 12/2/22 at 12:20pm, an annual inspection was made to the facility by Licensing Program Analyst (LPA), Erica Laird. At 1:20pm the home was toured inside and outside. The licensee and two assistants were supervising 10 children, and operating within the licensed capacity and ratio requirements. The facility’s operating hours are 6:30am-5:30pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the master bedroom, back bedrooms, laundry room, garage, and back yard shed, and were made inaccessible by door knob covers and locks. The children use the back yard as the outdoor play area and it is fully fenced. There is a in ground pool in the back yard. The pool is fully fenced with 5 foot mesh fencing.

Five children's records were reviewed at 1:00pm. Three staff records were reviewed at 1:15pm.

There are currently 3 adults living in the home. The Licensee was reminded that all adults 18 and over living or working in the home, 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: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: FOSTER, TIA FAMILY CHILD CARE HOME
FACILITY NUMBER: 585405321
VISIT DATE: 12/02/2022
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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.

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 Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) 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, available at: http://www.ada.gov/childqanda.htm

TThe following deficiencies were cited (see LIC 809D):



Exit interview conducted and report was reviewed with the licensee, Tia Foster.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
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Document Has Been Signed on 12/02/2022 01:39 PM - It Cannot Be Edited


Created By: Erica Laird On 12/02/2022 at 01:31 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: FOSTER, TIA FAMILY CHILD CARE HOME
FACILITY NUMBER: 585405321

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Assistant was missing immunization records and TB clearance, which poses a potential health, safety or personal rights risk to persons in care. Assistant states she is immunized and has been cleared for TB but does not have her documentation available right now.
POC Due Date: 12/16/2022
Plan of Correction
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Licensee agrees to obtain proof of vaccinations and TB clearance for assistant and provide proof to CCL by 12/16/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
SUPERVISOR'S NAME:Megan Aviles
LICENSING EVALUATOR NAME:Erica Laird
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022


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