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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 475408138
Report Date: 02/10/2023
Date Signed: 02/13/2023 07:39:54 AM

Document Has Been Signed on 02/13/2023 07:39 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:SISKIYOU INFANT & TODDLER CENTERFACILITY NUMBER:
475408138
ADMINISTRATOR:LUX, SUZIEFACILITY TYPE:
830
ADDRESS:170 BOLES ST.TELEPHONE:
(530) 938-2748
CITY:WEEDSTATE: CAZIP CODE:
96094
CAPACITY: 18TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/10/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Suzie Lux, ApplicantTIME COMPLETED:
03:45 PM
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A prelicensing inspection was conducted today at 1:30 p.m. by Licensing Program Analyst (LPA), N. Cunningham. LPA met with facility representative Suzie Luz.

LPA and Applicant Lux measured the space and discussed sleeping arrangements for the infants and toddlers.

A capacity worksheet was completed during the visit. There is enough indoor space for six infants and 12 toddlers. There are two toilets and four sinks available for children.

LPA will return to inspect the completed space. Applicant Lux will submit documents previously requested.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2023
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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