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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585405321
Report Date: 08/14/2024
Date Signed: 08/14/2024 11:21:06 AM

Document Has Been Signed on 08/14/2024 11:21 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:FOSTER, TIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
585405321
ADMINISTRATOR/
DIRECTOR:		FOSTER, TIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 741-9609
CITY:PLUMAS LAKESTATE: CAZIP CODE:
95961
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
08/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:41 AM
MET WITH:Tia FosterTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
NARRATIVE
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On 8/14/24 Licensing Program Analyst (LPA) Tammy Dutra conducted a case management visit and met with Licensee Tia Foster.

During the inspection, licensee's assistant S1 did not have a criminal record clearance on file and did not have eligible clearance on Guardian.

Licensee was issued a type A citation and a civil penalty of $100 dollars was issued for having a uncleared adult in the facility. Licensee is in the process of having assistant obtain live scan clearance and understands that assistant cannot return until they have a background clearance. Licensee had another assistant present who supported children in care until the assistant can get a background clearance.

LPA observed 12 children in care.

This report was reviewed and discussed with Licensee Tia Foster.

Notice of site visit was given and must be posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Tammy Dutra
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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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Document Has Been Signed on 08/14/2024 11:21 AM - It Cannot Be Edited


Created By: Tammy Dutra On 08/14/2024 at 10:56 AM
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: 08/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/14/2024
Section Cited
CCR
1596.871(c)(1)(A)

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Subsequent to initial licensure, a person specified subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision (f) of this section or
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Licensee sent S1 to get a livescan done and will not have them present in the home until criminal background clearance has been verified.
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Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
S1 did not have a criminal background clearance in Guardian
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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:Erin Virrueta
LICENSING EVALUATOR NAME:Tammy Dutra
LICENSING EVALUATOR SIGNATURE:
DATE: 08/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/14/2024


LIC809 (FAS) - (06/04)
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