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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115400726
Report Date: 04/10/2024
Date Signed: 04/10/2024 03:53:03 PM


Document Has Been Signed on 04/10/2024 03:53 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:CHAPMAN STREET HEAD START A-B-CFACILITY NUMBER:
115400726
ADMINISTRATOR:SILVIA C/KINKLE S/FRIAS AFACILITY TYPE:
850
ADDRESS:124 E. CHAPMAN STREETTELEPHONE:
(530) 865-1143
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY:60CENSUS: 0DATE:
04/10/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Wendi Callen, Miriam LopezTIME COMPLETED:
04:00 PM
NARRATIVE
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On 4/10/2024 at 2:30 pm, Licensing Program Analysts (LPA) J. Snow who met with Wendi Callen, Miriam Lopez in the Community Care licensing Department (CCLD) office to discuss potential applications on 3 existing facilities.
SUPERVISOR'S NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530) 215-6132
LICENSING EVALUATOR SIGNATURE:
DATE: 04/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/10/2024
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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