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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515406354
Report Date: 11/14/2019
Date Signed: 11/14/2019 02:44:39 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:BRITTAN STATE PRESCHOOLFACILITY NUMBER:
515406354
ADMINISTRATOR:KAELIN, STACIFACILITY TYPE:
850
ADDRESS:2340 PEPPER STREET, ROOM 27TELEPHONE:
(530) 822-5155
CITY:SUTTERSTATE: CAZIP CODE:
95982
CAPACITY:22CENSUS: 0DATE:
11/14/2019
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Staci KaelinTIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Martinez conducted an unannounced plan of correction visit and met with Director/Principal Staci Kaelin. Today's visit was to clear a citation issued on 11/7/19. The director did provide the LPA with POC documents on 11/13/19. During today's visit the director did show LPA child files and how they will remain accessible to LPA's during visits to include emergency identification documents, immunization's, receipt of parent rights, and consent for emergency medical treatment and other pertaining documents. LPA cleared the citation.

Notice of site visit must be posted for 30 days

No citations were issued.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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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