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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483000524
Report Date: 12/11/2020
Date Signed: 12/24/2020 01:19:47 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:BERT & ERNIE'S PRESCHOOLFACILITY NUMBER:
483000524
ADMINISTRATOR:BAILEY, TERRIFACILITY TYPE:
850
ADDRESS:255 NORTH LINCOLN STREETTELEPHONE:
(707) 678-4440
CITY:DIXONSTATE: CAZIP CODE:
95620
CAPACITY:83CENSUS: 14DATE:
12/11/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:20 PM
MET WITH:Terri Bailey TIME COMPLETED:
04:45 PM
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On 12/11/2020 at 4:20pm, Licensing Program Analyst (LPA) Laura Chavez conducted a case management inspection with Owner/Director Terri Bailey in response to the Confirmation of Removal dated October 30, 2020. The inspection was conducted via tele-inspection due to the current State of Emergency caused by COVID-19. The signed Confirmation of Removal received on November 9, 2020 indicates the individual was never employed. Based on evidence obtained during today’s tele-inspection, the LPA has verified the individual is not present, employed, or residing at the facility. The licensee was reminded that civil penalties and/or disciplinary action including suspension of her license could result if the individual is found working at the facility prior to the individual receiving a criminal record exemption.

All licensing reports are public information and must be made available upon request. At this time, there were no deficiencies noted of Title 22 Regulations. Verification of removal is complete.

SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2020
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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