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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317002780
Report Date: 01/05/2022
Date Signed: 01/05/2022 03:33:35 PM

Document Has Been Signed on 01/05/2022 03:33 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
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:
01/05/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Anna RyanTIME COMPLETED:
04:00 PM
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LPA Tryon visited the facility to do an annual visit. However, LPA could not get an annual document to open on the system. Therefore, LPA will return at another time to complete the visit.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 01/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/05/2022
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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