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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 041370593
Report Date: 10/25/2022
Date Signed: 10/25/2022 09:43:37 AM


Document Has Been Signed on 10/25/2022 09:43 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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926



FACILITY NAME:ORME FAMILY CHILD CARE HOMEFACILITY NUMBER:
041370593
ADMINISTRATOR:ORME, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 846-3901
CITY:GRIDLEYSTATE: CAZIP CODE:
95948
CAPACITY:12CENSUS: 11DATE:
10/25/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Susan OrmeTIME COMPLETED:
09:45 AM
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On 10/25/2022 at 9:05am, LPA Laura Chavez conducted a case management visit to the home. The inspection is a follow-up to the licensee, Susan Orme, notifying the Department of an in-ground pool installed in the backyard. During today’s visit, LPA observed the pool covered and labeled F-1346-91 as required and supports the weight of an adult.

There were no deficiencies cited during today’s inspection.

Notice of Site Visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2022
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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