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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045408226
Report Date: 07/27/2023
Date Signed: 11/17/2023 02:45:01 PM

Document Has Been Signed on 11/17/2023 02:45 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
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:ACORNS TO OAKS PRESCHOOL AND DAYCAREFACILITY NUMBER:
045408226
ADMINISTRATOR:SIVADON, SHANNONFACILITY TYPE:
830
ADDRESS:2448 TOM POLKTELEPHONE:
(530) 520-0251
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 11DATE:
07/27/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Erica Matzen, DirectorTIME COMPLETED:
03:15 PM
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On 7/27/23 @ 2:30pm licensing Program Analyst (LPA) E. Laird made an unannounced visit to the facility. LPA E. Laird met with facility director, Erica Matzen.

Notice of Site visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
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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