Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125402275
Report Date: 11/15/2017
Date Signed: 11/15/2017 08:59:30 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:SALMONBERRY PRESCHOOLFACILITY NUMBER:
125402275
ADMINISTRATOR:NUNLEY-MONAHAN, KATHLEENFACILITY TYPE:
850
ADDRESS:300 TRINITY STREETTELEPHONE:
(707) 677-0477
CITY:TRINIDADSTATE: CAZIP CODE:
95570
CAPACITY:30CENSUS: 4DATE:
11/15/2017
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Kathleen Nunley-MonahanTIME COMPLETED:
09:10 AM
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The LPA Snow met with the Director, Kathleen Nunley-Monahan to conduct a prelicensing inspection visit in response to a change request. The facility is decreasing capacity by removing a room from the license; they will only provide care in classroom #7 located on the Trinidad Elementary School. The facility has fire clearance and the LPA measured room # 7 to verify they have enough space for the requested capacity of 20.

The LPA will update the license with the reduced capacity. No violations were observed during the visit.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Jaime SnowTELEPHONE: (530) 215-6132
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2017
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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