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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 121373638
Report Date: 02/13/2024
Date Signed: 02/13/2024 12:15:23 PM

Document Has Been Signed on 02/13/2024 12:15 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:MISTWOOD MONTESSORI SCHOOLFACILITY NUMBER:
121373638
ADMINISTRATOR:FRINK, PATRICIA H.FACILITY TYPE:
850
ADDRESS:1801 TENTH ST.TELEPHONE:
(707) 444-8100
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY: 50TOTAL ENROLLED CHILDREN: 54CENSUS: 40DATE:
02/13/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Julie EitzenTIME COMPLETED:
12:30 PM
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LPAs K. Lynch and N. Wheeler visited the facility for the purpose of a case-management visit in response to an inquiry for lead reporting requirements. LPAs verified the lead testing was conducted by a local company on 05/24/22 per Licensee's lead report documentation. Licensee contacted company via phone during the visit to follow up on documentation being uploaded to the Water Board Database. No citations issued during today's visit. Exit interview conducted with Site Supervisor, appeal rights provided, notice of site visit provided.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 02/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2024
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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