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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 081303066
Report Date: 09/21/2023
Date Signed: 09/21/2023 02:44:36 PM

Document Has Been Signed on 09/21/2023 02:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO-DAY CARE, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:HEAD START - CRESCENT CITYFACILITY NUMBER:
081303066
ADMINISTRATOR:HAFLEY, GAYFACILITY TYPE:
850
ADDRESS:475 7TH STREETTELEPHONE:
(707) 464-1224
CITY:CRESCENT CITYSTATE: CAZIP CODE:
95531
CAPACITY: 24TOTAL ENROLLED CHILDREN: 16CENSUS: 0DATE:
09/21/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Gay HafleyTIME COMPLETED:
03:00 PM
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On 09/21/2023 at 2 PM, Licensing Program Analysts (LPA) K. Lynch and N. Wheeler made a case management inspection and met with facility representative. The inspection was made in response to a request to add the additional facility classroom into the licensed facility space. The facility will operate Monday-Friday, 7:45 AM – 5:15 PM. The facility will operate in two classrooms and there is one restroom for children with two sinks, one just outside the restroom, and two toilets, and one designated staff restroom. A capacity worksheet was previously completed for the facility, and capacity of 24 children will remain the same for the facility. Classroom drinking fountain was replaced and retested and cleared per facility representative and documentation was provided to Licensing. Fire clearance was previously approved for the classroom addition and received by Licensing 09/13/23. Room addition is approved as of today, 09/21/23. No deficiencies cited during today's visit. Exit interview conducted and report was reviewed with the facility representative Gay Hafley.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/21/2023
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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