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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009177
Report Date: 04/07/2022
Date Signed: 04/07/2022 01:24:33 PM

Document Has Been Signed on 04/07/2022 01:24 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:FATHER'S KIDS PRESCHOOL, THEFACILITY NUMBER:
483009177
ADMINISTRATOR:CONNOR, PAMELAFACILITY TYPE:
850
ADDRESS:4800 HORSE CREEK DRIVETELEPHONE:
(707) 455-7790
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 40DATE:
04/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Pamela ConnorTIME COMPLETED:
10:40 AM
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The Licensing Program Analyst Wisehart met with Director, Pamela Connor to discuss PIN 21-21 which was issued on 7/28/21 regarding Lead Testing Requirements. The PIN requires buildings built prior to 1/1/10 to be tested every five years. The building utilized by this day care was completed in 12/2015 and it's use started in 2/2016, therefore, the facility is not required to complete lead testing, unless a future PIN is issued rescinding PIN 21-21.

No deficiencies were cited during today's visit.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Carrie Wisehart
LICENSING EVALUATOR SIGNATURE: DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/07/2022
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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