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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045000644
Report Date: 11/20/2024
Date Signed: 11/20/2024 04:19:25 PM

Document Has Been Signed on 11/20/2024 04:19 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PRESTIGE ASSISTED LIVING AT CHICOFACILITY NUMBER:
045000644
ADMINISTRATOR/
DIRECTOR:
BLOW, SCOTTFACILITY TYPE:
740
ADDRESS:1351 E. LASSEN AVENUETELEPHONE:
(530) 899-0814
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY: 79TOTAL ENROLLED CHILDREN: 0CENSUS: 62DATE:
11/20/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:00 PM
MET WITH:Administrator, Scott BlowTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On November 20, 2024 at approximately 4:00 PM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Prestige Assisted Living At Chico for the purpose of conducting a Case Management-Other inspection regarding an appeal that was granted and the citation reduced down from a Type A Citation to a Type B Citation (See AMENDED LIC 809-Case Management-Deficiencies Inspection dated for July 31, 2024). LPA was greeted at the door by Administrator, Scott Blow and was granted access into the facility.

LPA delivered the amended report and the Type B Citation. LPA explained to the Administrator the importance of complying with Title 22 Regulations. LPA advised the Facility Administrator that if a similar occurrence happens the facility will be cited and the facility will be assessed a Civil Penalty.

No deficiencies were cited during today's Case Management-Other inspection. An Amended LIC 809-D Citation along with the AMENDED Case Management-Deficiencies Inspection Report dated for July 31, 2024 was given to the facility. Exit interview was conducted, and a copy of this report was signed and given to the Administrator.
Lauren CrockerTELEPHONE: (916) 202-0832
Farhaan SarangiTELEPHONE: (916) 307-0474
DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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