<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700523
Report Date: 02/28/2023
Date Signed: 02/28/2023 03:12:07 PM


Document Has Been Signed on 02/28/2023 03:12 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:VILLA SIERRA LODGE - SPENLOWFACILITY NUMBER:
342700523
ADMINISTRATOR:MAGPUSAO, LUALHATIFACILITY TYPE:
735
ADDRESS:5770 SPENLOW WAYTELEPHONE:
(530) 521-9632
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:4CENSUS: DATE:
02/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:TIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On February 28, 2023, Licensing Program Analyst (LPA) DeAnna Williams-Lyons attempted to conduct an annual inspection. LPA knocked on the door but no one answered. LPA will call the licensee. This is the 3rd time LPA made a visit to the home but no one was there. Will try again in the near future.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:
DATE: 02/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/28/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1