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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045000756
Report Date: 02/27/2026
Date Signed: 02/27/2026 11:11:25 AM

Document Has Been Signed on 02/27/2026 11:11 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ARC OF BUTTE COUNTY, THEFACILITY NUMBER:
045000756
ADMINISTRATOR/
DIRECTOR:		STEPHENS, SHELLEYFACILITY TYPE:
775
ADDRESS:2040 PARK AVETELEPHONE:
(530) 891-5865
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: 90CENSUS: 36DATE:
02/27/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:42 AM
MET WITH:Shelley Stephens,Administrator and Sarah Silva, Onsite AdministratorTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On February 27, 2026, Licensing Program Analyst (LPA) Kayla Adkison arrived at the facility unannounced to conduct a Required Annual Inspection. LPA met with Associate Director, Shelley Stephens, and On-site Administrator, Sarah Silva, and explained the purpose of the visit. At the time of the inspection, 18 clients and 7 staff were present in the facility. 20 additional clients and 6 staff were on a field trip to the Jelly Belly Factory. LPA observed clients participating in yoga class, playing games, and doing crafts.

The main facility (pavilion) is currently under construction and is unable to be used by clients due to mold being discovered during a renovation. The facility is temporarily utilizing four front office spaces as classrooms and clients are taking more outings into the community while the main pavilion is being completed.

LPA Adkison and Administrator toured the facility together to ensure the health and safety of clients in care. Areas toured include but are not limited to: four activity rooms/classrooms, storage areas, kitchen, a common room, and two (2) bathrooms. All clients bring their lunch from home, however, the facility was providing a pizza party for clients during the inspection. The facility has a plethora of activities for client use including, games, puzzles, and art supplies. There is a calendar of activities, events, and classes, posted for clients to observe and sign up for each day.

All areas observed were found to be clean and in good repair. LPA observed all walkways to be free of clutter or obstructions. All clients bring their lunches from home. There are additional snacks available for clients. LPA observed all, cleaning supplies, medications, and other toxins to be locked away and inaccessible to clients in care. LPA reviewed the Medication Administration Record (MAR) for one (1) client and found it to be in compliance.

The facility was observed to be at a comfortable temperature. Fire extinguishers were fully charged and last inspected in September 2025. Carbon monoxide detectors were observed and were in working order. The facility's temporary space did not have a smoke detector. A maintenance worker obtained a smoke detector during the visit and had it installed while LPA was in the facility. The last disaster drill was conducted and documented in January 2026. The facility is conducting drills monthly.

LPA reviewed five (5) staff files and five (5) client files which contained all the required documentation. All employees requiring background checks are cleared. All CPR/First Aid training was current.

No deficiencies are being cited as a result of this inspection. Exit Interview conducted. A copy of this report and Appeal Right were provided to Shelley Stephens, Associate Director, via email
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Kayla Adkison
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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