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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045408526
Report Date: 11/20/2024
Date Signed: 11/20/2024 02:28:16 PM

Document Has Been Signed on 11/20/2024 02:28 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:E CENTER HS PGMS - GRIDLEY WESTFACILITY NUMBER:
045408526
ADMINISTRATOR/
DIRECTOR:
MACLEAN, CELESTEFACILITY TYPE:
860
ADDRESS:295 WASHINGTON STTELEPHONE:
(530) 846-3123
CITY:GRIDLEYSTATE: CAZIP CODE:
95948
CAPACITY: 28TOTAL ENROLLED CHILDREN: 28CENSUS: 0DATE:
11/20/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Karen Fukushima TIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Karen Fukashima met with the licensing program analyst (LPA) Jaime Snow to discuss the pending application to
decrease to 28 capacity &add toddlers. Applicant is requesting 20 preschool & 8 toddlers (was 38 preschool only)
A1. LIC200A (Application) Please correct preschool age 2-6 years & update hours of operation to match daily children’s schedule (mail original)
A5. LIC309 Administrative Organization - send an updated version as the terms expire on 12/24.
A9. LIC500 Personnel Report – add one more preschool teacher
A14. LIC 999 Facility Sketch -must be completed to meet updated standards- list available.
A15. Fire Clearance – a new one was ordered with both room #s, they typically sign those without needing to
reinspect. Please follow up with the fire department.
B2. Director Qualifications- D- Celeste (existing director) please submit:
Current Pediatric first Aid and CPR, as the one you sent was missing the EMSA
*we did received proof of backup staff with this requirement
B14. Background Clearance or Exemption – Please associate AR- Jodie Keller as the licensee/applicant -45408526 -E CENTER HS PGMS - GRIDLEY WEST
Pending waiver for shared preschool toddler play yard: please provide the manufacturers ages on the existing
climbing structure.

Please submit the items listed above so an inspection can be scheduled.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jaime Snow
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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