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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317003105
Report Date: 07/26/2023
Date Signed: 08/08/2023 11:51:40 AM

Document Has Been Signed on 08/08/2023 11:51 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
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: 3DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Sophia SneedTIME COMPLETED:
04:00 PM
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On 7/26/2023 LPA Tryon visited the facility to conduct an annual visit. LPA met with staff Sophia Sneed. The facility currently has 3 residents.
LPA did a brief tour of the home and spoke with staff.
Due to late start of visit and facility schedule, LPA will return at a later date in the near future to complete the annual visit and to complete the CARE Tool.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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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