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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002948
Report Date: 10/18/2022
Date Signed: 10/18/2022 02:34:21 PM

Document Has Been Signed on 10/18/2022 02:34 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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:WTC NEXUS CHICOFACILITY NUMBER:
045002948
ADMINISTRATOR:GLADU, ELISEFACILITY TYPE:
775
ADDRESS:2201 PILLSBURY ROAD SUITE 142TELEPHONE:
(530) 343-7994
CITY:CHICOSTATE: CAZIP CODE:
95926
CAPACITY: 44CENSUS: 0DATE:
10/18/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Elise Gladu - Assistant ManagerTIME COMPLETED:
03:00 PM
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10/18/2022 2:00 PM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility to conduct a scheduled pre-licensing inspection. 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, gloves. LPA met with Elise Gladu Assistant Manager, Community Programs Manager Christina Crabb, Elise Daniels Assistant Manager and explained the purpose of the visit.

LPA and facility staff toured the facility inside and out. The fire marshal has approved the fire safety inspection request. The facility is licensed for a total capacity of 44 ambulatory clients. The facility has 5 fully charged fire extinguishers which were inspected by the fire marshal. LPA observed smoke alarms and carbon monoxide detectors throughout the facility which are wired directly to the fire department.

Passageways and exits are free of obstructions. There are no pool/body of water present.

The inside of the facility was observed to be in good condition and repair. The facility has two (2) bathrooms, one (1) kitchen, one (1) large common area, one (1) conference room/office, shaded outdoor area, and storage areas. Lighting was observed to be adequate.

Bathrooms were observed to be in good repair. The bathrooms are set up with paper towels and soap for hand washing.

The facility will not be storing medications..

There is a locked storage area for chemicals and disinfectants. Sharps and dangerous items will be locked and will be inaccessible to clients. Staff files will be electronic and will be readily available to view. Facility has working phone number (530) 343-7994 x 4013.

The applicants have passed the pre-licensing portion of the application process. LPA will contact the Central Application Bureau.

No deficiencies according to CCR Title 22, Division 6. Exit Interview and copy of report was emailed to Elise Gladu.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
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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