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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700044
Report Date: 10/31/2022
Date Signed: 10/31/2022 05:12:57 PM


Document Has Been Signed on 10/31/2022 05:12 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:OLTEAN'S HOME CAREFACILITY NUMBER:
342700044
ADMINISTRATOR:OLTEAN, DIANNEFACILITY TYPE:
740
ADDRESS:4213 WALNUT AVETELEPHONE:
(916) 484-1763
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 5DATE:
10/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:35 PM
MET WITH:Dacia FletcherTIME COMPLETED:
05:55 PM
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On 10/31/2022, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Caregiver, Dacia Fletcher, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols and the daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical mask and face shield.

Caregiver informed LPA there are (5) residents in the facility, and (1) resident on hospice services. LPA observed the facility to be licensed for capacity of 6 and a hospice waiver of 4.

LPA informed Caregiver to contact Licensee, Dianne Oltean, regarding the inspection. Licensee informed LPA she cannot make it but Caregiver is authorized to tour the facility with LPA. LPA stated the report will be signed by caregiver and report will be emailed to Licensee. LPA toured the facility to ensure the health and safety of the resident in care. Areas toured include but are not limited to: bedrooms, kitchen, bathroom, dining room, and common areas. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Caregiver completed the infection control domain.

LPA observed the posted Administrator Certificate to be expired 5/15/22 but LPA confirmed on CCLD website that Administrator Certificate #6040232740 has been renewed.

At this time, LPA requested a copy of the Administrator Certificate, LIC 308, LIC 500 and Liability Insurance to be emailed or faxed to LPA by November 7, 2022.

No deficiencies are being cited.

Exit interview conducted and copy of report will be emailed to Licensee.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 10/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/31/2022
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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