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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125408329
Report Date: 02/12/2025
Date Signed: 02/12/2025 04:00:26 PM

Document Has Been Signed on 02/12/2025 04:00 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:CAL POLY HUMBOLDT CHILDREN'S CENTER RM#104,108,125FACILITY NUMBER:
125408329
ADMINISTRATOR/
DIRECTOR:		WILSON, ELIZABETH-ANNEFACILITY TYPE:
850
ADDRESS:1350 C STREETTELEPHONE:
(707) 826-3838
CITY:ARCATASTATE: CAZIP CODE:
95521
CAPACITY: 58TOTAL ENROLLED CHILDREN: 34CENSUS: 27DATE:
02/12/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Betsy WilsonTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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An unannounced case management inspection was conducted today at 2:30 PM by Licensing Program Analysts (LPA) Noah Wheeler and Kiriko Lynch. LPAs met with facility representative Betsy Wilson in response to an Unusual Incident Report received by the Department on 01/24/2025. LPAs conducted interviews and toured the facility in regard to the incident reported. Further investigation is needed at this time. No citations issued during today's visit. Exit interview conducted with Director Betsy Wilson, appeal rights provided, and notice of site visit posted.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Noah Wheeler
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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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