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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002107
Report Date: 12/21/2022
Date Signed: 12/21/2022 12:58:30 PM

Document Has Been Signed on 12/21/2022 12:58 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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:SKILLS DEVELOPMENT CENTERFACILITY NUMBER:
455002107
ADMINISTRATOR:CRAVENS, JENNIFERFACILITY TYPE:
775
ADDRESS:160 MASONIC AVENUETELEPHONE:
(530) 245-1734
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 75CENSUS: 49DATE:
12/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:50 AM
MET WITH:Jennifer CravensTIME COMPLETED:
01:10 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA wore a surgical mask during visit and observed all staff wearing surgical masks.

This facility is in the same building as a thrift store. The have separate entrances to keep them separated. There is a large main common area with a couple of offices, a quiet room, changing room, and restrooms. LPA inspected the personal protective equipment supply during tour and observed the residents and staff interacting with each other.

Several topics were discussed.

No deficiencies cited.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/21/2022
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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