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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005332
Report Date: 06/15/2022
Date Signed: 07/01/2022 11:08:23 AM


Document Has Been Signed on 07/01/2022 11:08 AM - 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:CHRISMAN COMMUNITYFACILITY NUMBER:
347005332
ADMINISTRATOR:CLAUDIA MIHAIFACILITY TYPE:
740
ADDRESS:4230 PARADISE DRIVETELEPHONE:
(916) 515-8590
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 6DATE:
06/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Claudia MihaiTIME COMPLETED:
10:45 AM
NARRATIVE
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Licensing Program Analyst (LPAs) Cassie Yang and Kevin Mknelly arrived to the facility unannounced to conduct a case management visitation. LPAs spoke with Administrator, Claudia Mihai, and Licensee, Emilia Ardelean, regarding the current lease agreement of the facility.

LPAs followed department covid precautions. LPAs were not screened upon arrival. LPAs wore surgical masks.

LPA's found that S1 had not been fingerprinted yet has been present at the facility for 3 days. S1 is to leave the facility until cleared and associated.

LPAs found that in the process of change of ownership, the current licensee is not leasing the property. LPAs advised that the lease be transferred back to the current licensee no later that Friday, 6/17/22. Proof of a lease for current licensee to be sent to LPA Yang.

Residents have received the 60-day notice on 4/26/22.

As a result of todays inspection, deficiency was found.

Report reviewed copy or report and appeal rights provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2022
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 2


Document Has Been Signed on 07/01/2022 11:08 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926


FACILITY NAME: CHRISMAN COMMUNITY
FACILITY NUMBER: 347005332

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/16/2022
Section Cited

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Criminal record clearance (b) Prior to the Department issuing a license, the applicant, administrator and any adults other than a client, residing in the facility shall have a criminal record clearance or exemption. This requirement was not met based on S1 is present for three days without clearance.
This posed a risk to residents.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2022
LIC809 (FAS) - (06/04)
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