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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002191
Report Date: 05/26/2021
Date Signed: 05/26/2021 03:00:41 PM

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:SIERRA OAKS OF REDDING MEMORY CAREFACILITY NUMBER:
455002191
ADMINISTRATOR:BOBAN, KRISTINEFACILITY TYPE:
740
ADDRESS:1620 COLLYER DRTELEPHONE:
(530) 241-5100
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:28CENSUS: 20DATE:
05/26/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Mindy Rachel, Assistant DirectorTIME COMPLETED:
03:15 PM
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5/26/2021 2:40 PM Licensing Program Analyst (LPA) Rebecca Knight arrived unannounced to conduct a case management inspection. LPA met with Mindy Rachel, Assistant Director and explained purpose of inspection.

The purpose of this visit is to deliver the “Order to Licensee/Facility of Immediate Exclusion From Facility" for prior employee, Hunter Wilson. LPA delivered notice of "Immediate Exclusion" to Assistant Director Mindy Rachel, LPA spoke to Ms. Rachel and explained the "Immediate Exclusion" notice indicating that prior employee, Hunter Wilson cannot be allowed to work, be present and/or live in a CCL licensed facility and have contact with clients in any residential facility or child day care licensed by the California Department of Social Services. Mindy Rachel indicated she understands the notice and confirmed that Hunter Wilson was officially off the facility payroll as of 1/15/2021.

Exit interview done. Copy of report left with Mindy Rachel at the facility.
SUPERVISOR'S NAME: Rayna L BrysonTELEPHONE: (530) 895-5991
LICENSING EVALUATOR NAME: Rebecca KnightTELEPHONE: (530) 895-4356
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021
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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