<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 123007003
Report Date: 08/16/2023
Date Signed: 08/16/2023 12:01:21 PM


Document Has Been Signed on 08/16/2023 12:01 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:MACY, MARY FCCHFACILITY NUMBER:
123007003
ADMINISTRATOR:MACY, MARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 725-1525
CITY:FORTUNASTATE: CAZIP CODE:
95540
CAPACITY:14CENSUS: 9DATE:
08/16/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Mary MacyTIME COMPLETED:
12:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Lynch visited the home for the purpose of a POC visit for a deficiency cited 06/01/2023 for a complaint regarding the odor of cat urine in the home. During today's visit, LPA met with Licensee, and LPA observed new flooring was installed throughout the areas of the family child care home, and the smell of cat urine was currently not noticeable in the home. LPA cleared the deficiency at the time of the visit. Exit interview conducted, and notice of site visit posted. No Title 22 deficiencies were cited during today's visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Kiriko LynchTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1