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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 325002814
Report Date: 12/14/2022
Date Signed: 12/14/2022 02:47:24 PM

Document Has Been Signed on 12/14/2022 02:47 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:HOULIHAN'S PLACEFACILITY NUMBER:
325002814
ADMINISTRATOR:HOULIHAN-RALPH, CHERIFACILITY TYPE:
735
ADDRESS:320 MOODY MEADOW ROADTELEPHONE:
(530) 258-4326
CITY:CHESTERSTATE: CAZIP CODE:
96020
CAPACITY: 4CENSUS: 2DATE:
12/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:37 PM
MET WITH:Cheri HoulihanTIME COMPLETED:
03:00 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA wore a surgical mask and observed all staff wearing masks.

The main entrance opens in the main common area. The main common area has the kitchen, dining, and living space. There is a door in the back of the kitchen/dining area that leads to the laundry room and door the backyard. There is a hallway on the left that leads to two shared resident rooms, two rooms for the licensees, one full common bathroom, and one of the licensee's room has a full private bathroom. There are locked cabinets for medications and files. Personal protective equipment supply was observed.


Multiple topics discussed.

No deficiencies cited.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 12/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/14/2022
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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