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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002725
Report Date: 11/28/2023
Date Signed: 11/28/2023 01:03:33 PM

Document Has Been Signed on 11/28/2023 01:03 PM - 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:WTC, NEXUS OROVILLEFACILITY NUMBER:
045002725
ADMINISTRATOR:MACIAS, ANITAFACILITY TYPE:
775
ADDRESS:2075 BALDWIN AVETELEPHONE:
(530) 924-2303
CITY:OROVILLESTATE: CAZIP CODE:
95965
CAPACITY: 44CENSUS: 32DATE:
11/28/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Anita Macias - administratorTIME COMPLETED:
01:00 PM
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11/28/2023 12:30 PM Licensing Program Analyst Rebecca Knight conducted an unannounced case management visit and met with administrator Anita Macias. Today’s visit is regarding an incident that occurred on 11/09/2023 and was reported to licensing on 11/10/2023.

It was reported that on 11/09/2023 Client 1 (C1) was on a community outing and was sitting next to Client 2 (C2) in the facility van. When C1 got off the van they reported to staff that C2, who was seated next to C1, touched C1’s body. C1 reported that they told C2 "that was not OK." C1 stated they told C2 a few times to stop and it's not OK.

During the course of the investigation, it was learned that eight clients went on an outing to the park. On the return trip there were 2 staff and 8 clients on the bus. C1 did not say anything to staff until they return to program and told the administrator. Administrator talked to both clients, C2 denied touching C1 and stated that C1 had touched them on the leg. Neither client had any additional information to add.

In order to prevent this from happening again the day program has made sure that the two involved clients are not going on the same outings and staff have been asked to monitor them.

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

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2023
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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