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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002476
Report Date: 12/07/2021
Date Signed: 12/07/2021 02:01:27 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 12/07/2021 02:01 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:OASIS RESIDENTIAL PROGRAM-WESTFACILITY NUMBER:
455002476
ADMINISTRATOR:SHANE CLARKFACILITY TYPE:
735
ADDRESS:16625 HWY 299 WESTTELEPHONE:
(530) 524-6684
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY: 4CENSUS: 0DATE:
12/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:42 PM
MET WITH: Derrick Cobb house managerTIME COMPLETED:
01:43 PM
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An unannounced required visit was conducted by Misty Valencia Licensing Program Analyst (LPA) . During the visit, LPA met with Derrick Cobb, who reported that they are in the process of rebuilding the property. They property was burnt down in the July 2018 Carr Fire.

Cobb reports that he will keep LPA Valencia updated of any and all changes.


No deficiencies were cited during today's visit
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2021
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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