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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700739
Report Date: 10/12/2022
Date Signed: 10/12/2022 04:14:39 PM


Document Has Been Signed on 10/12/2022 04:14 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:PINES, THEFACILITY NUMBER:
312700739
ADMINISTRATOR:HENRY COLEFACILITY TYPE:
740
ADDRESS:500 W RANCHVIEW DRIVETELEPHONE:
(916) 672-5019
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:142CENSUS: 103DATE:
10/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Henry ColeTIME COMPLETED:
04:25 PM
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Licensing Program Analyst(LPA) Hiratsuka, conducted this unannounced annual visit. LPA observed staff wearing masks during this visit. LPA wore a surgical mask during this visit. LPA toured with Katherine Kaveta, Garden House Director. LPA also spoke with Henry Cole, General Manager.

The fire clearance is for 127 non-ambulatory residents and twelve bedridden residents for a total of 142 residents The assisted living section has forty-five studio with one bathroom apartments, twenty-six one bedroom and one bathroom apartments, two two bedroom and one bathroom apartments, and four two bedroom and two bathroom apartments. All assisted living apartments have kitchenettes. The assisted living side has many common areas, a dining area, a theater, salon, medication room, laundry room that staff use and two laundry room that residents may use, and several outside areas. The memory care unit is enclosed with a delayed egress and it has nine studio apartments and forty six semi-private apartments and all have bathrooms. The memory care has a capacity of 55 residents. The memory care apartments do not have kitchenettes. The memory care unit has two enclosed outside courtyards, medication room, salon, dining room, laundry room that only staff have access to, and several common areas for residents

Multiple topics were discussed during this visit.

No deficiencies cited.

SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2022
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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