Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455400688
Report Date: 12/09/2015
Date Signed 12/09/2015 09:33:36 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:GIBSON-CASSIDY, ELAINE FAMILY DAY CAREFACILITY NUMBER:
455400688
ADMINISTRATOR:GIBSON-CASSIDY, ELAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 605-0930
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:14CENSUS: 3DATE:
12/09/2015
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Patricia DessauerTIME COMPLETED:
09:45 AM
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A visit was made to the facility in response to a citation issued during a random visit on 11/25/2015. During the 11/25/15 visit the licensee was cited for the following:

Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of
children for whom care. There were 18 children in care. This presents an immediate risk to the health
and safety of children in care.

During the 11/25/15 visit the licensee agreed to remain within her licensed capacity and ratio allowances. The licensee has handed out copies of the type A violation issued on 11/25/15 and has the notice of site visit posted. The licensee was not at home at the beginning of today's visit. Ms. Dessauer is one of the licensee's assistants and was providing care to three children. Ms. Dessauer has current CPR and first aid cards. The licensee arrived prior to the visit's completion. No further action by the licensee is required at this time. All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Lisa McKayTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jordan MonathTELEPHONE: (530) 513-1214
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2015
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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