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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001498
Report Date: 07/15/2021
Date Signed: 07/16/2021 08:34:48 AM

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:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR:TINA PREWITTFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:45CENSUS: 43DATE:
07/15/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Tina PrewittTIME COMPLETED:
04:30 PM
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On this date, LPA Tryon arrived at the facilty to follow up to make sure a former staff member is no longer working at the facility. LPA met with Administrator Tina Prewitt regarding former staff S1. An order has been granted by the court stating that S1 is prohibited from being a licensee, owning a beneficial ownership interest of 10 percent or more of a licensed facility, or being an administrator, officer, director, member, or manager of a licensee or entity controlling a license, and from employment in, presence in and contact with clients of any facility licensed by the Department. Respondent is also excluded from presence in any resource family home, from employment in presence in and contact with clients of any facility licensed by the Department, or certified or approved by a licensed foster family agency, and from holding the position of member of the board of directors, executive director or officer of the licensee of any facility licensed by the Department.

Ms, Prewitt stated the S1 had worked at Citrus Heights Terrace for a short time, but has not worked there for many months. She understands that S1 is no longer allowed to work or be present in a facility licensed by the Department.

LPA provided a copy of the Court Order dated July 9, 2021 .to Ms. Prewitt.

Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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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