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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317002780
Report Date: 09/20/2021
Date Signed: 09/21/2021 11:43:54 AM

Document Has Been Signed on 09/21/2021 11:43 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:RYAN FAMILY CARE HOMEFACILITY NUMBER:
317002780
ADMINISTRATOR:ERIC RYANFACILITY TYPE:
735
ADDRESS:12285 RIO OSO ROADTELEPHONE:
(530) 269-1892
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY: 6CENSUS: 6DATE:
09/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Debbie Ryan, Anna RyanTIME COMPLETED:
01:00 PM
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LPA Tryon arrived at the facility on 9/20/21 to perform an annual visit using the Infection Control Domain. Prior to the visit, LPA had checked with the facility to ensure they do not have any COVID Positive Residents or staff. LPA did a self-screening by taking temperature and reviewing possible symptoms. LPA wore a surgical mask and used hand sanitizer. LPA met with Licensee Debie Ryan and Anna Ryan.

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

LPA reviewed the infection control domain LPA requested a copy of most recent Administrator Certificate, copy of liability insurance, and current staff schedule.

A Technical Advisory was issued regarding N-95 Fit Testing. The facility is in the process of finding a resource.

The facility appears to be in substantial compliance at this time.

Exit interview conducted
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/20/2021
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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