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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475406362
Report Date: 09/19/2024
Date Signed: 09/19/2024 11:54:44 AM

Document Has Been Signed on 09/19/2024 11:54 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:ROTH, PEGGY FAMILY CHILD CARE HOMEFACILITY NUMBER:
475406362
ADMINISTRATOR/
DIRECTOR:		ROTH, PEGGYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 598-8805
CITY:YREKASTATE: CAZIP CODE:
96097
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/19/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:50 AM
MET WITH:Peggy Roth, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:05 PM
NARRATIVE
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On 9/19/24 at 10:50am, Licensing Program Analyst (LPA) Kayla Danielson and Nicolette Cunningham conducted an unannounced inspection, and met with licensee Peggy Roth. Today's inspection was conducted to verify the plan of correction for four Type B citations that were issued on 8/15/24.

Type B issued on 8/15/24 – facility roster
During today’s inspection, the licensee stated she has been busy cleaning so she has not had time to complete the roster. Licensee stated she will add all children in care for the last three years to her roster and submit to CCL by 9/30/24.

Type B issued on 8/15/24 –mandated reporter training
During today’s inspection, the licensee stated she is unable to locate her certificate of completion and unable to recall when she completed the training. The licensee stated her assistant has not completed the mandated reporter training because she does not typically employ an assistant. At approximately 11:45am, the licensee's assistant completed the training and provided certificate of completion.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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 09/19/2024 11:54 AM - It Cannot Be Edited


Created By: Nicolette Cunningham On 09/19/2024 at 11:23 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: ROTH, PEGGY FAMILY CHILD CARE HOME
FACILITY NUMBER: 475406362

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2024
Section Cited
CCR
102417(8)

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(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
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The licensee stated she will add all children that have atttended her FCCH for the last three years and submit a copy to LPA Cunningham by 9/30/24.
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Based on interviews and record review, the licensee did not comply with the section cited above in one out of one roster was not completed which creates a potential health, safety or personal rights risk to persons in care.
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Type B
10/03/2024
Section Cited
HSC1596.8662(b)(1)

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(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
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The licensee stated her assistant will complete the mandated reporter training within the next two weeks and send proof to LPA Cunningham.
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Based on observation, interview, record review, the licensee did not comply with the section cited above in one staff member was unable to provide proof of mandated reporter training which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2024


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Document Has Been Signed on 09/19/2024 11:54 AM - It Cannot Be Edited


Created By: Nicolette Cunningham On 09/19/2024 at 11:34 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: ROTH, PEGGY FAMILY CHILD CARE HOME
FACILITY NUMBER: 475406362

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/26/2024
Section Cited
CCR
102417(g)(1)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.
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The licensee stated she will purchase a 2A10BC fire extinguisher.
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This requirement is not met as evidenced by:
On 9/19/24, the licensee did not have a 2A10BC fire extinguisher in the home.
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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:Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2024


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: ROTH, PEGGY FAMILY CHILD CARE HOME
FACILITY NUMBER: 475406362
VISIT DATE: 09/19/2024
NARRATIVE
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Type B citations issued on 8/15/24 –fire extinguisher
During today’s inspection, LPAs observed a new fire extinguisher rated 1A10BC. Regulations require all facility to maintain a 2A10BC fire extinguisher. The licensee stated she will purchase a 2A10BC.

Type B issued on 8/15/24 – children’s immunization records
During today’s inspection, the licensee stated she does not currently have children in care because they are attending elementary school. The licensee reviewed regulation 102418 and signed stating that she understands the regulation.

The following deficiencies were cited: no 2A10BC fire extinguisher, assistant did not have mandated reporter training and no facility roster available.



A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee P. Roth.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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