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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317000237
Report Date: 02/27/2023
Date Signed: 02/27/2023 02:48:32 PM


Document Has Been Signed on 02/27/2023 02:48 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:OAKWOOD VILLAGE, INC.FACILITY NUMBER:
317000237
ADMINISTRATOR:JOHN O'BRIENFACILITY TYPE:
740
ADDRESS:3388 BELL ROADTELEPHONE:
(530) 889-8122
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:124CENSUS: 52DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:John O'BrienTIME COMPLETED:
03:30 PM
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LPA Tryon arrived at the facility on 2/27/23 to perform an annual visit using the Infection Control Domain. Prior to the visit, LPA did a self-screening for COVID symptoms. LPA wore a surgical mask and washed my hands prior to entering the building. LPA met with Administrator John O'Brien.

LPA toured the facility including common areas, kitchen, dining rooms, resident bedrooms, bathrooms, hallways, yard.

LPA reviewed the infection control domain with the Administrator.

The facility has performed FIT testing for staff. Facility has an Infection Control Plan in place and has done staff training on the plan.

The facility appears to be insubstantial compliance at this time.

Exit interview conducted
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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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