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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125406801
Report Date: 12/19/2023
Date Signed: 12/19/2023 02:15:13 PM

Document Has Been Signed on 12/19/2023 02:15 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:CRENSHAW, SUMER FAMILY CHILD CARE HOMEFACILITY NUMBER:
125406801
ADMINISTRATOR:CRENSHAW, SUMERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 223-4600
CITY:FORTUNASTATE: CAZIP CODE:
95540
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
12/19/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sumer CrenshawTIME COMPLETED:
01:30 PM
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LPA K. Lynch, LPM E. Virrueta, and Licensee met on MS Teams to discuss an incident which occurred on 08/07/2023. Details of the incident were discussed, including current care and supervision, and mitigation of future potential incidents including the correction plan and physical plant elements. No Title 22 deficiencies cited during today's meeting.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Kiriko Lynch
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2023
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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