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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045408064
Report Date: 06/19/2024
Date Signed: 06/19/2024 12:27:28 PM

Document Has Been Signed on 06/19/2024 12:27 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:APPLEGATE, TRACIE FAMILY CHILD CARE HOMEFACILITY NUMBER:
045408064
ADMINISTRATOR/
DIRECTOR:		APPLEGATE, TRACIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 282-7991
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
06/19/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Tracie Applegate, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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On 6/19/24 @ 12:15pm Licensing Program Analyst (LPA) Erica Laird conducted an unannounced case management inspection. LPA Laird met with licensee, Tracie Applegate. Tracie stated she would like to go inactive effective today, 6/19/24 through 6/9/2025. LPA Laird obtained an inactive form from licensee.
SUPERVISORS NAME: Megan Aviles
LICENSING EVALUATOR NAME: Erica Laird
LICENSING EVALUATOR SIGNATURE: DATE: 06/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/19/2024
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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