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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515407329
Report Date: 10/25/2019
Date Signed: 10/25/2019 08:38:14 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:GISH, CHELSEA FAMILY CHILD CARE HOMEFACILITY NUMBER:
515407329
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
10/25/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Chelsea MeyerTIME COMPLETED:
08:45 AM
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Licensing Program Analyst (LPA) Martinez conducted an unannounced visit and met with licensee Chelsea Meyer. Today's visit was conducted due to an increase of capacity application received in the office on 9/18/19. The LPA received a fire clearance on 10/17/19 at the regional office. During today's visit LPA conducted a tour of the facility for on limits areas of the home. LPA discussed with the licensee that the area that is off limits to children in the backyard should be partitioned off by a gate to distinguish which areas are for use. The main daycare area of the home is the two front rooms next to the kitchen. The home was observed clean and orderly and at a comfortable temperature. Based on observations of today's inspection, the increase of capacity will be approved once a photo of the backyard off limits area is sent to the CCLD office.

Notice of site visit must be posted for 30 days. No citations were issued during today's visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
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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