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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002633
Report Date: 12/15/2022
Date Signed: 12/15/2022 12:29:54 PM


Document Has Been Signed on 12/15/2022 12:29 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:A TOUCH OF HEAVENFACILITY NUMBER:
455002633
ADMINISTRATOR:PRATHER, SARAHFACILITY TYPE:
740
ADDRESS:760 KERRYJEN CTTELEPHONE:
(530) 226-5052
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:28CENSUS: 16DATE:
12/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sarah Prather and Tricia HopperTIME COMPLETED:
12:40 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA wore a surgical mask during this visit and observed all staff wearing surgical masks.

This facility is a horseshoe shape building. There are 24 resident rooms and a couple of them are shared. There is an office, laundry room, kitchen, and several common areas. The front area has an open courtyard. This facility has a fire clearance for 28 bedridden. The entire facility is enclosed with a fence that has delayed egress that is cleared.

Multiple topics were discussed.


No deficiencies cited.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
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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