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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002628
Report Date: 01/14/2025
Date Signed: 01/14/2025 12:16:03 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/14/2025 12:16 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MOUNTAIN MEADOW LODGEFACILITY NUMBER:
045002628
ADMINISTRATOR/
DIRECTOR:		KEENE, CLIFFFACILITY TYPE:
740
ADDRESS:585 BILLE RDTELEPHONE:
(530) 872-9002
CITY:PARADISESTATE: CAZIP CODE:
95969
CAPACITY: 17TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Administrator- Cliff Keene TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 01/14/2025, Licensing Program Analyst (LPA) Ivan Avila arrived unannounced to conduct a Required-1 Year Inspection. LPA met with Administrator Cliff Keene at Westmont of Chico-Inn At The Terraces (2950 SIERRA SUNRISE TERRACE Chico CA 95928) and explained the purpose of the visit.

This facility was destroyed as a result of the 2018 Camp Fire and there are no residents in care. The licensee wishes to maintain the license in the event the facility is rebuilt.

No deficiencies are being cited in today’s visit.

Exit interview conducted and copy of report was provided to Cliff Keene.
Anthony PerezTELEPHONE: (323) 485-4915
Ivan AvilaTELEPHONE: (559) 974-4915
DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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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