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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700638
Report Date: 10/31/2022
Date Signed: 10/31/2022 04:59:21 PM


Document Has Been Signed on 10/31/2022 04:59 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:ESTHER CARE HOMEFACILITY NUMBER:
342700638
ADMINISTRATOR:EGUAVOEN, CHARLESFACILITY TYPE:
740
ADDRESS:4415 ROLLINGROCK WAYTELEPHONE:
(916) 560-3800
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: DATE:
10/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:TIME COMPLETED:
04:36 PM
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On 10/31/2022, Licensing Program Analyst (LPA) Cassie Yang at the facility unannounced to conduct an annual inpsection. LPA observed the driveway to be empty. LPA looked through the window and observed the facility to be empty. LPA contacted the facility number at 916-560-3800 and there was no answer.

LPA will return at a later date to complete annual inspection.
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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