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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455407903
Report Date: 08/16/2024
Date Signed: 08/16/2024 09:29:53 AM

Document Has Been Signed on 08/16/2024 09:29 AM - 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:LACKEY, CHEYENNE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455407903
ADMINISTRATOR/
DIRECTOR:		LACKEY, CHEYENNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 768-6397
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
08/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Cheyenne Lackey, LicenseeTIME VISIT/
INSPECTION COMPLETED:
09:40 AM
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On 8/16/24 at approximately 9:10am, Licensing Program Analyst (LPA) Kayla Danielson and Nicolette Cunningham conducted an inspection at the facility in order to obtain the licensee's signature on LIC9111. LPAs observed the licensee and assistant providing care for nine preschool age children.

This report was discussed and reviewed with the licensee.
Notice of Site Visit shall be posted for 30 days.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Nicolette Cunningham
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2024
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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