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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407941
Report Date: 03/22/2024
Date Signed: 03/22/2024 10:20:14 AM

Document Has Been Signed on 03/22/2024 10:20 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:E CENTER PGMS - BIRD STREETFACILITY NUMBER:
045407941
ADMINISTRATOR:MENDENHALL,FRANCINEFACILITY TYPE:
830
ADDRESS:1421 BIRD STREETTELEPHONE:
(530) 712-2030
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
03/22/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Karen FukushimaTIME COMPLETED:
10:30 AM
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Office meeting to meet with, Admistrator, Karen Fukushima to discuss the application to add a Modular Unit and increase the capacity from 76 preschool to 95 preschool. The following documents were requested:

• LIC200A (Application) version dated 3/23 – needed (can wait until visit)
(Jodie Keller applicant & Francine Mendenhall director/no changes)
• Application fee paid $25
• Board Resolution (Corporation) received 1/24/24
• LIC309 (Administrative Organization) expired, please update
• LIC610 (Emergency and Disaster Plan) -letters of permission-Cant be a licensed site. Please update one for main building and another for the modular
• LIC500 received 3/22/24
• Facility Sketch, Please send updated sketches: showing all areas to be used, with dimensions of all rooms and yard areas; include bathrooms, toilets sinks room numbers as discussed. The maps will need to be updated. Isolation room, number of toilet/sink etc
• Waiver requests, if any None
• Control of property :received
• Admission Agreement – approved 3/22/24
• Parent Handbook – No changes per Karen 3/22/2024
• Job descriptions – No changes per Karen 3/22/2024
• Mandated reporter training for current director
• CPR& First aid for current director – others on site have CPR/FA
• Fire Clearance will be reordered-
• Additional documents & managerial review will be required
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2024
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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