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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 295002880
Report Date: 01/06/2025
Date Signed: 01/06/2025 02:39:25 PM

Document Has Been Signed on 01/06/2025 02:39 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:ODYSSEY HOUSEFACILITY NUMBER:
295002880
ADMINISTRATOR/
DIRECTOR:
PHENIX, DIANE LCSWFACILITY TYPE:
772
ADDRESS:995 HELLING WAYTELEPHONE:
(530) 265-7222
CITY:NEVADA CITYSTATE: CAZIP CODE:
95959
CAPACITY: 16CENSUS: 13DATE:
01/06/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Renate HarbourTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 1/6/2025 LPA Tryon visited the facility to perform a required annual visit. LPA met with staff Renate Harbour and Jennifer Bente . LPA toured the facility including common areas, kitchen, dining room, offices, hallways, bedrooms, medication room, laundry, storage, outside smoking and recreation areas.

The facility appears in good condition, clean and well-furnished. Food supplies were reviewed and there is plenty of fresh, perishable and non-perishable food. Food appears to be stored appropriately and of good variety and quality. Cleaning supplies are locked. Laundry room is furnished with multiple machines, and chemicals are locked. Storage for cleaners is locked. The front of the building is comprised of multiple offices and a conference/activity room. Living room is spacious and nicely furnished.

Bedrooms are clean and include appropriate furniture as per regulation. Bathrooms were functional and clean. Outside area offered plenty of room for smoking, a basketball hoop, etc.
Smoke detector/sprinkler system is installed; fire extinguishers present and charged.
LPA noted no hazards throughout the facility.

LPA reviewed the CARE Tool with staff.
LPA reviewed 4 staff files and 4 client files. LPA interviewed one staff and 2 residents.

LPA finds documentation to be complete. The facility appears to be in substantial compliance at this time. No deficiencies were noted. Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2025
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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