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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002476
Report Date: 03/07/2023
Date Signed: 03/07/2023 10:38:36 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/07/2023 10:38 AM - 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,
, CA
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:
03/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Joel Dooley - AdministratorTIME COMPLETED:
10:50 AM
NARRATIVE
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Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Required 1 Year Annual Inspection Visit. LPA explained purpose of visit with Administrator. Licensee may rebuild on the property in the future. The property burnt down in the July 2018 Carr Fire.

No deficiencies were cited during today's visit

Exit interview conducted and a copy of report left with administrator.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Ruth Wallace
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2023
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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