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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 480101831
Report Date: 10/22/2021
Date Signed: 10/22/2021 12:44:20 PM

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:ORCHARD AVE BAPTIST PRESCHOOLFACILITY NUMBER:
480101831
ADMINISTRATOR:REYNOLDS, JENNIFERFACILITY TYPE:
850
ADDRESS:301 N ORCHARD AVETELEPHONE:
(707) 448-5868
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY:34CENSUS: 11DATE:
10/22/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Jennifer ReynoldsTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Mikah Martinez and Kirk Marks conducted an unannounced case management visit in regards to the room addition for the facility to utilize as a Kindergarten room. During todays visit Room E1, E2, E3, C4, and the Main Preschool room were measured for 34 children. E1 can hold up to 7 children at one time. E2 can hold up to 6 children at one time. E3 can hold up to 5 children at one time, C4 can hold up to 11 children at one time. The main preschool room can hold up to 26 children at one time. The Department received a fire clearance on 10/5/21 for a total of 34 children that was approved. A new license will be provided to the facility.

Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021
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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