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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 451373915
Report Date: 01/10/2022
Date Signed: 01/10/2022 09:01:21 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:WOODCLIFF CARE HOMEFACILITY NUMBER:
451373915
ADMINISTRATOR:CALLOWAY, JAIMEFACILITY TYPE:
740
ADDRESS:165 WOODCLIFF DRIVETELEPHONE:
(530) 244-2467
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:6CENSUS: DATE:
01/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Administrator Jamie CallowayTIME COMPLETED:
09:30 AM
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On 01/10/2021, Licensing Program Analyst (LPA) Misty Valencia conducted an unannounced required-1 year annual visit and met with Administrator Jamie Calloway and explained the reason for the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted Administrator and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical MASK. Additionally, LPA was screened by the Administrator.

LPA Valencia and Mr. Calloway toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common area, six (6) private resident bedrooms, three (3) bathrooms, kitchen, storage areas, and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA Valencia and the Administrator completed the infection control domain and facility was found to be in substantial compliance at this time.



No deficiencies are being cited as a result of todays inspection. Technical assistance was provided.

Exit interview conducted and copy of report was emailed to Administrator Calloway.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Misty ValenciaTELEPHONE: (530) 895-5820
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
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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