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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525405509
Report Date: 01/07/2022
Date Signed: 01/07/2022 01:12:56 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:JACKSON HEIGHTS STATE PRESCHOOLFACILITY NUMBER:
525405509
ADMINISTRATOR:BRIGGS, KRISTENFACILITY TYPE:
850
ADDRESS:225 JACKSON STREEETTELEPHONE:
(530) 529-6741
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:24CENSUS: 9DATE:
01/07/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Alyssa McCombs, Director of Early Childhood Programs and Kristen BriggsTIME COMPLETED:
11:00 AM
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A Case Management Visit was conducted by Licensing Program Analyst, Wisehart who met with Alyssa McCombs, Director of Early Childhood Programs and Site Supervisor, Kristen Briggs.

The visit was initiated by the licensee who requested an expansion to the outdoor play yard. The facility is licensed for 24 children. The LPA toured the facility and playground and measured the additional space at 10:35 am. The new addition has been approved for use and the playground now measures for a capacity of 67 children in the outdoor space, however, the license capacity remains at 24 children.

No deficiencies were cited during today's visit. An exit interview was conducted and appeal rights provided.
A Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2022
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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