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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045001959
Report Date: 03/02/2021
Date Signed: 03/03/2021 08:07:46 AM

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., STE. 170
CHICO, CA 95926
FACILITY NAME:WINDCHIME OF CHICOFACILITY NUMBER:
045001959
ADMINISTRATOR:DAVID, RACHELFACILITY TYPE:
740
ADDRESS:855 BRUCE RDTELEPHONE:
(530) 566-1800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:120CENSUS: 51DATE:
03/02/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Administrator Rachel DavidTIME COMPLETED:
09:45 AM
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On 3/2/21 at 9 AM, Community Care Licensing (CCL) held a virtual Office meeting with Windchime of Chico at Windchime of Chico's request. Present at the meeting was Administrator Rachel David, Chief Clinical Officer Roz Watson, Attorney Joel Goldman, CDSS Attorney Steven Becker, Licensing Program Manager Rayna Bryson, Licensing Regional Manager Alycia Berryman and Licensing Program Analyst Jaclyn Avila.

Windchime of Chico requested the meeting to propose a change in staffing ratios that were agreed upon in the Stipulations and Waiver; and Order in November 2018 by both licensee and CCL.

CCL requested the following from Windchime of Chico: Proposal in writing, census data 2018-present, staffing schedules 2018-present, Milestone Emergency Response Policy, call light response time 2018-present, and history of internal complaints/concerns due by Monday March 8th, 2021

LPA will review CCLD complaint history 2018-present

No citations were issued during today's visit.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jaclyn AvilaTELEPHONE: (530) 895-4275
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2021
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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