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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317005671
Report Date: 07/29/2022
Date Signed: 07/29/2022 03:16:18 PM


Document Has Been Signed on 07/29/2022 03:16 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:ALMOND GARDENSFACILITY NUMBER:
317005671
ADMINISTRATOR:NISHA PATELFACILITY TYPE:
740
ADDRESS:174 ALMOND STREETTELEPHONE:
(530) 885-5678
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY:10CENSUS: 0DATE:
07/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Jennifer ClarkTIME COMPLETED:
04:00 PM
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LPA Tryon visited the facility on 7/29/2022 to conduct an annual visit. The home is currently empty, and has not had residents for over 2 years. The facility does have a mitigation plan in place, as well as a new Infection Control Plan. LPA met with Administrator Jennifer Clark.

LPA reviewed the infection control domain of the CARES tool with the Administrator. Although the faclity has no residents at this time, the plan is ready in case residents do move in.

LPA and Administrator did a walk-thru of the facility to inspect basic requirements.

The home appears to be in compliance, and is ready to accept residents should the occasion arise in the near future.

No deficiencies cited at this visit. Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2022
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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