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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045001802
Report Date: 09/28/2023
Date Signed: 09/28/2023 11:28:28 AM

Document Has Been Signed on 09/28/2023 11:28 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:LIGHTHOUSE LIVING SERVICES, INC.FACILITY NUMBER:
045001802
ADMINISTRATOR:FERRONE, MICHAELFACILITY TYPE:
775
ADDRESS:2065 BIRD STREETTELEPHONE:
(530) 534-9237
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 30CENSUS: 20DATE:
09/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michael Ferrone - admininstratorTIME COMPLETED:
11:30 AM
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09/28/2023 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with administrator Michael Ferrone and explained the purpose of the visit.

LPA Knight and the administrator toured the facility together to ensure the health and safety of clients who attend program. Areas toured include but are not limited to common areas, two (2) bathrooms, kitchen, storage areas. Staff and resident files were reviewed. All employees requiring background checks are cleared.

There is a schedule of recreational activities planned for the clients and clients are given the choice to participate in these activities.

The facility was observed to be at a comfortable temperature. Common area was clean and in good repair. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Fire extinguishers fully charged and were inspected in August 2022 and are due for inspection by the fire marshal. Smoke detectors are all operational. No pools/bodies of water are on premises. No firearms are on premises. Last disaster drill was conducted in August 2023 which was a fire drill, the facility has been conducting fire drills monthly.

In the areas toured no immediate health, safety, or personal rights violations were observed. No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was provided to administrator Michael Ferrone.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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