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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002725
Report Date: 10/03/2022
Date Signed: 10/03/2022 10:15:22 AM

Document Has Been Signed on 10/03/2022 10:15 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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:WTC, NEXUS OROVILLEFACILITY NUMBER:
045002725
ADMINISTRATOR:DANIELS, ELISEFACILITY TYPE:
775
ADDRESS:2075 BALDWIN AVETELEPHONE:
(530) 343-7994
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 44CENSUS: 14DATE:
10/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Anita Macias - DSP 3TIME COMPLETED:
10:30 AM
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10/03/2022 9:30 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with DSP 3 Anita Macia, administrator Elise Daniels was unavailable, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask. Additionally, LPA Knight was screened by facility staff.

LPA Knight and Ms. Macias toured facility together to ensure health and safety of clients who attend program. Areas toured include but are not limited to: common areas, bathrooms, and storage rooms. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Knight and Ms. Macias completed the infection control domain and facility was found to be in substantial compliance at this time.

No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was emailed to Anita Macias.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2022
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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