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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045001065
Report Date: 07/16/2024
Date Signed: 07/16/2024 11:13:13 AM

Document Has Been Signed on 07/16/2024 11:13 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:WADE CARE HOMEFACILITY NUMBER:
045001065
ADMINISTRATOR/
DIRECTOR:		LYNETTE WADEFACILITY TYPE:
735
ADDRESS:67 RIVERVIEW TERRACETELEPHONE:
(530) 533-4630
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 5CENSUS: 1DATE:
07/16/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Lynette Wade - LicenseeTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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07/16/2024 09:30 AM Licensing Program Analyst Rebecca Knight conducted an unannounced case management visit and met with licensee Lynette Wade. Today’s visit is regarding an incident that occurred on 07/02/2024 and was reported to licensing on 07/03/2024.

It was reported that on 07/02/2024 at approximately 6:50 pm Licensee and Client 1 (C1) were on the upper floor of the facility and heard a noise. Licensee discovered that an occupant of the home that is not a client had sustained a serious bodily injury. Licensee rendered aid to the occupant, called 911, and called a neighbor for help. The neighbor moved C1 to the kitchen. The occupant was transported to the hospital. Licensee was unable to reach their emergency back up staff and took C1 with them to the hospital.The licensee notified C1’s conservator, family, and Far Northern Regional Center of the incident. The client was unharmed.

No deficiencies are being cited as a result of the investigation. Exit interview was conducted and the report was provided to licensee Lynette Wade.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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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