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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455403102
Report Date: 12/22/2022
Date Signed: 12/22/2022 11:37:21 AM


Document Has Been Signed on 12/22/2022 11:37 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:TRINITY LUTHERAN SCHOOL AGE PROGRAMFACILITY NUMBER:
455403102
ADMINISTRATOR:CONNOR, CRYSTALFACILITY TYPE:
840
ADDRESS:2440 HILLTOP DRIVETELEPHONE:
(530) 221-6686
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:46CENSUS: 0DATE:
12/22/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Crystal Connor, DirectorTIME COMPLETED:
12:30 PM
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A case management visit was conducted to the facility by LPA N. Cunningham in response to room change request by the licensee. The facility is currently licensed to occupy room 5, the fellowship hall, and gymnasium for a total capacity of 46. The licensee requested a room change from room 5 to room 3. The Redding Fire Department approved the space on 11/23/22. There will be no change to the outdoor play yard, which is currently licensed for 46. There are six toilets and six hand washing sinks which is sufficient for 46 children. The fenced play area is equipped with shade and cushioning material (pea gravel) under the climbing structure to absorb falls.

The room change is approved, effective 12/22/22.

Notice of Site Visit shall be posted for 30 days from today's visit
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 966-0216
LICENSING EVALUATOR NAME: Nicolette CunninghamTELEPHONE: (530) 521-5235
LICENSING EVALUATOR SIGNATURE:
DATE: 12/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2022
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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