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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515402793
Report Date: 03/24/2022
Date Signed: 03/25/2022 04:52:31 PM

Document Has Been Signed on 03/25/2022 04:52 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:ANDRUS FAMILY CHILD CARE HOMEFACILITY NUMBER:
515402793
ADMINISTRATOR:ANDRUS, MARILYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 682-2266
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY: 14TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
03/24/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Marilyn Andrus, LicenseeTIME COMPLETED:
01:00 PM
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*This is an amended report.
Licensing Program Analysts (LPA) J. Helton and N. Cunningham made an unannounced Plan of Correction (POC) Inspection as a follow for the deficiency that was cited on 03/16/22; where the Licensee was cited a Type A deficiency for failing to ensure an adult (Adult 1) received criminal record clearance. The licensee provided the location that Adult 1 is currently residing at. The licensee stated that she understands that Adult 1 is unable to be at the property until they obtain a fingerprint clearance through Community Care Licensing. LPAs toured the facility's interior on limit areas. LPAs did not observe Adult 1 present at the facility. LPA Cunningham cleared the type A deficiency that was cited on 03/16/22 and provided the POC Clearance Letter to the Licensee. This report was discussed and reviewed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

POC Clearance Letter, clearing a type A deficiency must be posted for 30 days from today's inspection.

Notice of Site Visit shall be posted for 30 days from today's inspection.

There were no Title 22 deficiencies cited during today's inspection. Appeal rights were provided.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2022
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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