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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002928
Report Date: 08/29/2022
Date Signed: 08/29/2022 05:52:45 PM

Document Has Been Signed on 08/29/2022 05:52 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:ASPEN RIDGE COMMUNITIES LLC 2FACILITY NUMBER:
345002928
ADMINISTRATOR:VINSON, DEONTEEFACILITY TYPE:
735
ADDRESS:4424 PENWITH WAYTELEPHONE:
(916) 450-9206
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 6CENSUS: 6DATE:
08/29/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:NaTasha Harden, LicenseeTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Jacob Williams met with facility Licensee NaTasha Harden to conduct a Pre- Licensing visit. LPA followed current Covid precautions: self-screened, hand sanitized and surgical mask was worn.

The facility has a fire clearance for 2 ambulatory and 4 non-ambulatory clients. Room #1 is approved for one (1) non-ambulatory and one (1) ambulatory room #2 approved for one (1) ambulatory, room #3 approved for two (2) non-ambulatory, and room #4 non-ambulatory.



LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) resident bedrooms, and two (2) resident bathrooms. LPA observed facility to be properly furnished, including appropriate bedding and lighting in the facility. Bathrooms are in sanitary condition and properly maintained. LPA obtained approval from LPM on lack of side gate and fence slightly leaning over on east side of house.

LPA checked the kitchen area for the ability to prepare and store food. LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors at the care home to be operational. Fire extinguisher and first aid kit are maintained and ready for emergency use.

Licensee will submit photo evidence of CCL's LET-US-NO poster once it has arrived and been posted.

Pre-licensing passed and Component III (ARF) was completed with NaTasha. Facility has satisfied all requirements in accordance to Title 22, California Code of Regulations. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted and copy of report left at facility.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Jacob Williams
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2022
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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