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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004533
Report Date: 08/24/2022
Date Signed: 08/24/2022 01:43:19 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 08/24/2022 01:43 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:OLIVE OAKS CAREFACILITY NUMBER:
347004533
ADMINISTRATOR:OVIDIU BARBUFACILITY TYPE:
740
ADDRESS:7833 OLIVE STREETTELEPHONE:
(916) 536-0764
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY: 6CENSUS: 0DATE:
08/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Barbu OvidiuTIME COMPLETED:
01:45 PM
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On 8/18/22, LPA Kevin Mknelly attempted a Annual Inspection.
There was no answer to two rings of the doorbell, a call to the house phone nor a call to the mobile phone of record. LPA emailed the licensee to notify them of the visit attempt.
Licensee phoned LPA at approximately 12:45 to notify them that the home is vacant and has been for a few months.
There are no pending admissions or assessments. Licensee and LPA scheduled a return for inspection for next week.

On 8/24/22, Licensing Program Analyst (LPA) Kevin Mknelly arrived. LPA met with Ovidiu Barbu, Administrator, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing and screening protocols. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by staff upon entry and signed visitor log with temperature.

LPA toured the facility to ensure the health and safety of residents in care. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator reviewed the infection control domain topics and facility was found to be in substantial compliance at this time.

LPA reviewed Infection Control Plan requirements and that annual fees are do.

No deficiencies are being cited. Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/18/2022
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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