<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 310305150
Report Date: 04/29/2022
Date Signed: 05/02/2022 10:09:32 AM

Document Has Been Signed on 05/02/2022 10:09 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:TAYLOR'S RESIDENCEFACILITY NUMBER:
310305150
ADMINISTRATOR:DONALD AND GINA WALLACEFACILITY TYPE:
735
ADDRESS:375 PLACER STREETTELEPHONE:
(530) 885-7306
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 15CENSUS: 15DATE:
04/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Gina WallaceTIME COMPLETED:
04:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst Tryon arrived at the facility unannounced on 4/29/22 to conduct a Required-1 Year Inspection utilizing the infection control domain, LPA met with Gina Wallace and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 screening LPA applied hand sanitizer before entering the facility and wore a surgical mask.

LPA and admin toured facility together to ensure health and safety of residents in care. Areas toured include common areas, resident bedrooms, bathrooms, kitchen, and front yard. Food supply looks adequate, cleaning supplies, etc. Facility has an adequate supply of PPE. . LPA and administrator 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 todays inspection.
Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1