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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125406277
Report Date: 03/08/2024
Date Signed: 03/08/2024 10:45:26 AM


Document Has Been Signed on 03/08/2024 10:45 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:DAVISON, ANNA FAMILY CHILD CARE HOMEFACILITY NUMBER:
125406277
ADMINISTRATOR:DAVISON, ANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 616-5060
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY:14CENSUS: 8DATE:
03/08/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Anna DavisonTIME COMPLETED:
11:00 AM
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LPAs N. Wheeler and K. Lynch visited the home for the purpose of amending a report from 12/01/23. LPAs met with the Licensee and toured the home and observed care and supervision provided to children at the home. No Title 22 deficiencies cited during today's visit. Exit interview conducted, and Notice of Site Visit posted.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Noah WheelerTELEPHONE: 530-895-5033
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
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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