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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317003105
Report Date: 09/19/2022
Date Signed: 09/19/2022 03:34:02 PM

Document Has Been Signed on 09/19/2022 03:34 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:SCHNEIDER FAMILY HOMEFACILITY NUMBER:
317003105
ADMINISTRATOR:LEE, NICOLEFACILITY TYPE:
735
ADDRESS:455 RIVERVIEW DRIVETELEPHONE:
(530) 745-9872
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 6CENSUS: 5DATE:
09/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Nicole LeeTIME COMPLETED:
03:30 PM
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On 9/19/2022 LPA Tryon visited the facility to do an annual visit using the Infection Control Domain of the CARES Tool.
LPA reviewed the Infection Control domain with the Administrator.

LPA toured the house including common areas, kitchen, food supplies, bedrooms, bathrooms, hallways, storage area, garage. The facility has adequate supply of perishable and non-perishable food, adequate supply of PPE, cleaning supplies, etc.

The facility appears to be in substantial compliance with the regulations at this time.
No deficiencies were cited at this visit.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2022
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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