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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 255407644
Report Date: 03/27/2024
Date Signed: 03/28/2024 08:38:45 AM


Document Has Been Signed on 03/28/2024 08:38 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 CC RO, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:ANDERSON, AMBER FAMILY CHILD CARE HOMEFACILITY NUMBER:
255407644
ADMINISTRATOR:ANDERSON, AMBERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 708-1760
CITY:ALTURASSTATE: CAZIP CODE:
96101
CAPACITY:14CENSUS: DATE:
03/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
05:08 PM
MET WITH:Amber AndersonTIME COMPLETED:
05:15 PM
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On 3/27/2024 during an annual inspection made by LPA Tammy Dutra , LPA had to leave during inspection and return to complete inspection at a later time. When LPA returned, the annual inspection was completed. Report was reviewed with Licensee Amber Anderson.

Notice of site visit given to Licensee and must be posted for 30 days.

Appeal Rights were given to Licensee Amber Anderson..
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Tammy DutraTELEPHONE: (530) 806-3471
LICENSING EVALUATOR SIGNATURE:
DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/27/2024
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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