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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125406606
Report Date: 02/07/2024
Date Signed: 02/07/2024 09:25:49 AM

Document Has Been Signed on 02/07/2024 09:25 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-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:SURBAUGH, NINA FAMILY CHILD CARE HOMEFACILITY NUMBER:
125406606
ADMINISTRATOR:SURBAUGH, NINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 832-6327
CITY:MCKINLEYVILLESTATE: CAZIP CODE:
95519
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
02/07/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Nina SurbaughTIME COMPLETED:
10:00 AM
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LPAs N. Wheeler and K. Lynch conducted a POC visit in response to a violation cited during a visit to the facility on 01/30/2024. During the visit on 01/30/2024, facility was cited for being out of ratio by having 9 children in care and just one staff present. During the visit conducted today on 02/07/2024, Licensee and Assistant were both present with 11 children were in care, 2 infants and 9 preschool aged. The facility is within compliance, and no violations are cited.

Notice of Site Visit must be posted for 30 days.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Noah Wheeler
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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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