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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407998
Report Date: 03/11/2022
Date Signed: 03/11/2022 02:12:43 PM

Document Has Been Signed on 03/11/2022 02:12 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:BRUMBAUGH, JULIE FAMILY CHILD CARE HOMEFACILITY NUMBER:
045407998
ADMINISTRATOR:BRUMBAUGH, JULIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 363-7571
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
03/11/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Julie BrumbaughTIME COMPLETED:
10:06 AM
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A prelicensing inspection was conducted today at 10:00am by Licensing Program Analyst (LPA), Mendez LPA met with applicant/licensee Julie Brumbaugh. The applicant is requesting a change a license for a capacity of 14. The facility will operate Monday-Friday, 6:00am to 6:00pm. The residence is a 5 bedroom/ 3 bathroom one story home. There is one adult living in the home. A fire clearance was granted on 3/7/22 for a capacity for 14.

The home and yard were toured, and the facility sketch was verified. The following areas will be off limits to children: two bedrooms, one bathroom and garage and laundry room. Baby gates are used to prevent access to off limits area of the home.
Any cleaning products are stored in the cabinet above in the laundry room. The home is equipped with a working smoke detector and fire extinguisher rated at least 2A10BC. The licensee stated the gas insert fireplace will not be utilized during child care hours and is does not operate. The children will use the backyard as the outdoor play area. The backyard is completely fenced. There is no pool, spa, pond, fountain, or any other body of water on the premises.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

(Continued on 809C)
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: BRUMBAUGH, JULIE FAMILY CHILD CARE HOME
FACILITY NUMBER: 045407998
VISIT DATE: 03/11/2022
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Applicant/Licensee/Facility representative was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant/licensee/facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant/licensee/facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The physical plant is ready, and the requested items have been submitted.
The facility is licensed effective , March 11, 2022

Exit interview conducted and report was reviewed with the applicant/licensee/facility representative Julie Brumbaugh.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Bianca Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022
LIC809 (FAS) - (06/04)
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