Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455400688
Report Date: 02/21/2019
Date Signed 02/21/2019 10:42:22 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:GIBSON-CASSIDY, ELAINE FAMILY DAY CAREFACILITY NUMBER:
455400688
ADMINISTRATOR:GIBSON-CASSIDY, ELAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 605-0930
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:14CENSUS: 0DATE:
02/21/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Elaine Gibson-CassidyTIME COMPLETED:
10:50 AM
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A case management inspection was conducted by Licensing Program Analyst (LPA) Patricia Pacheco at the facility at the request of the licensee. The licensee converted a formerly inaccessible office into a play room for the children in care. LPA observed that the room is equipped with age appropriate toys and furniture. LPA observed that the flooring has been repaired and new carpet has been installed. LPA approved the room for use during child care hours.

This report was reviewed with the licensee. Notice of site visit must be posted for 30 days from today's date.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2019
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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