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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125408207
Report Date: 12/16/2022
Date Signed: 12/16/2022 11:49:25 AM

Document Has Been Signed on 12/16/2022 11:49 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:HUMBOLDT COUNTY OFFICE OF EDUCATION - SPECIAL BEGFACILITY NUMBER:
125408207
ADMINISTRATOR:HUGHES, MICHAELFACILITY TYPE:
850
ADDRESS:901 MYRTLE AVETELEPHONE:
(707) 540-5692
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/16/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Genna AdamsTIME COMPLETED:
12:00 PM
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A prelicensing inspection was conducted by Licensing Program Analyst (LPA) Kiriko Lynch in response to an application received on 10/11/22. The facility was toured inside and outside, and the floor and yard plan submitted by the licensee were verified. Licensee is a public agency, Humboldt County Office of Education. One partial day program will run out of the Franklin site preschool classroom for children 3 to 5 years of age, Monday through Friday, 8 AM to 12 AM, with an additional 12 to 2 PM option Monday through Thursday. Program has toys, play equipment, and furniture set up in the classroom for children to use. Program will serve snack for the program and utilize water container and cups and also bottled water available for children. The indoor space of the facility space was measured and is sufficient for the requested capacity of 24 preschool children. The outdoor fenced play area was measured and is sufficient for up to 12 children at a time. The program has requested a waiver for the outdoor space, and program will alternate recess times for additional children in the program. The fire clearance was received by Licensing and was approved by the local fire authority on 12/01/22. The facility has restroom fixtures sufficient for the capacity, and isolation room is located nearby in a separate room.

Facility is licensed today 12/16/22.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/16/2022
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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