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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 297003934
Report Date: 10/07/2022
Date Signed: 10/10/2022 01:32:12 PM

Document Has Been Signed on 10/10/2022 01:32 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:ALL-STAR PROGRAMSFACILITY NUMBER:
297003934
ADMINISTRATOR:COOK, JEFFERY C.FACILITY TYPE:
775
ADDRESS:10140 WILD TURKEY LANETELEPHONE:
(530) 432-6564
CITY:SMARTSVILLESTATE: CAZIP CODE:
95977
CAPACITY: 24CENSUS: 8DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:JC CookTIME COMPLETED:
01:00 PM
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LPA Tryon visited the day program on 10/7/2022. LPA met with JC Cook.
LPA toured the day program site. The program has been in session on a remote basis, and has not used the physical site for a couple of years. However, the physical plant is still furnished.
LPA reviewed the Infection Control Section of the CARES Tool with staff. The facility does have a plan in place for the time that the program goes back on-site.

No deficiencies noted at this visit.
Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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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