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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515402793
Report Date: 06/15/2022
Date Signed: 06/15/2022 10:22:43 AM

Document Has Been Signed on 06/15/2022 10:22 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
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: 14CENSUS: 10DATE:
06/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH:Marilyn AndrusTIME COMPLETED:
10:30 AM
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On 6/15/2022 from 10:05 am Licensing Program Analyst (LPA) J. Helton conducted a Case Management unannounced inspection for follow up on allegation of uncleared adult living in the home. The adult is not currently living in the home, he is living in Woodland at a rehab facility, he is expected to stay up to another 6 months, and possibly continue living in Woodland after. Licensees assistant was interviewed at 10:21 AM and stated she has never seen the adult son in the home.
Per Licensee her adult son was never living here, nor working here therefore she did not get the DOJ clearance.

On this date of 6/15/2022 During this Case Management inspection, LPA observed that adequate care and supervision was being provided including that staffing ratios were being met and the facility was operating within the licensed capacity.

Licensee has filed an appeal regarding the allegation, stated has not heard anything in return.

This report was reviewed and discussed with Licensee Marilyn Andrus. 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. There were no Title 22 deficiencies cited during today's inspection
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Jackie Helton
LICENSING EVALUATOR SIGNATURE: DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/15/2022
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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