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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 12:28:29 PM


Document Has Been Signed on 12/15/2022 12:28 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:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sarah Prather and Tricia HopperTIME COMPLETED:
12:40 PM
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LPA Hiratsuka conducted this unannounced case management visit. LPA wore a surgical mask during this visit and observed all staff wearing surgical masks.

This facility reported someone who passed away. The death report didn't have enough details. Facility is waiting for the death certificate. LPA obtained more information and will wait for the death certificate.

LPA conducted an unannounced annual visit today. During the visit a resident climbed over the perimeter fence using outdoor furniture. Resident admitted it. Facility staff are aware the resident normally walks the perimeter of the facility and check on resident on a regular basis. Resident was found and brought back in. Written report is going to be sent to LPA. Administrator stated she is going to work on updated care plan and assessment.


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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