Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455400688
Report Date: 11/16/2017
Date Signed 11/16/2017 03:24:36 PM

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: 14DATE:
11/16/2017
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Elaine Gibson-CassidyTIME COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
A case management inspection was conducted at the facility by LPA Patricia Pacheco in regards to a self-reported incident that was called into the Department by the licensee on 11/06/17. The licensee reported that she had just become aware of allegations of possible inappropriate touching between children in the home that may have happened on 08/11/17. LPA toured the facility, reviewed records and conducted interviews. During the inspection, the licensee's two assistants were appropriately supervising the children in care. The licensee arrived during the inspection after picking up 2 additional children. As soon as the licensee arrived, 2 children who had already been at the facility were picked up. Based on available information, at this time there is not sufficient proof indicating a violation occurred.

Notice of site visit must be posted for 30 days from today's date.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2017
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1