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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 451370383
Report Date: 11/10/2020
Date Signed: 11/12/2020 07:53:16 AM

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:BUCKEYE SCHOOL OF ARTS CHILDREN CENTERFACILITY NUMBER:
451370383
ADMINISTRATOR:BARRY, KATHYFACILITY TYPE:
850
ADDRESS:3499 HIATT DRIVETELEPHONE:
(530) 225-0356
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:27CENSUS: 0DATE:
11/10/2020
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Brandy GrovesTIME COMPLETED:
08:45 AM
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The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak. The facility is currently inactive with no staff and no children; so the visit was conducted with Brandy Graves, the Administrator from the Shasta County Office Of Education.

Based on the evidence obtained during today’s visit, the LPA has verified the individual is not present, employed or residing at the facility. LPA has advised the licensee to disassociate the individual from their roster and she has already submitted an updated LIC 500.

Verification of removal is complete.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530) 215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020
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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