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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455001380
Report Date: 03/29/2022
Date Signed: 03/29/2022 08:41:46 PM

Document Has Been Signed on 03/29/2022 08:41 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:BRAVO PROGRAMFACILITY NUMBER:
455001380
ADMINISTRATOR:TRANTHAM, TRISHFACILITY TYPE:
775
ADDRESS:9560 CROSSROADS DRIVETELEPHONE:
(530) 221-5251
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 30CENSUS: 25DATE:
03/29/2022
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Trish TranthamTIME COMPLETED:
09:00 AM
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On 03/29/2022, Licensing Program Analysts (LPAs) Misty Valencia and Shannon Diegoruelas conducted an announced complaint investigation visit regarding the above allegation directed by the department. LPAs met with Trisha Trantham , Administrator 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 staff at the front door.

This is a collateral visit to interview clients at day program.

Complaint allegation needs further investigation.

No deficiencies during todays visit. Exit interview conducted and a copy of report was emailed to Administrator
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2022
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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