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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
515400854
Report Date:
08/12/2021
Date Signed:
08/12/2021 10:10:22 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:
MARCUM-ILLINOIS PRESCHOOL
FACILITY NUMBER:
515400854
ADMINISTRATOR:
EGGERS, JIMMIE
FACILITY TYPE:
850
ADDRESS:
2452 EL CENTRO BLVD.
TELEPHONE:
(530) 656-2407
CITY:
E. NICOLAUS
STATE:
CA
ZIP CODE:
95659
CAPACITY:
36
CENSUS:
0
DATE:
08/12/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
09:30 AM
MET WITH:
Shasta Ford
TIME COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA) Martinez and Grisak conducted a visit to the Marcum-Illinois Preschool which is requesting a room 17 be added to the use of the preschool license. Currently the license is for 36 children in room 16. The applicants are asking to keep the capacity the same but add room 16 to allow for smaller groups. During todays visit LPAs toured and measured room 17 which allows for 21 children with two toilets and three sinks. Room 16 and the outside play area have already been licensed. As of todays date the facility has not been inspected by the fire marshal for addition to the room.
Notice of site visit must be posted for 30 days.
No citations were issued.
SUPERVISOR'S NAME:
Erin Virrueta
TELEPHONE:
(530) 895-4325
LICENSING EVALUATOR NAME:
Mikah Martinez
TELEPHONE:
(530) 895-4014
LICENSING EVALUATOR SIGNATURE:
DATE:
08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/12/2021
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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