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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002663
Report Date: 10/27/2021
Date Signed: 10/27/2021 07:46:52 PM

Document Has Been Signed on 10/27/2021 07:46 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:CURTIS HOMESFACILITY NUMBER:
455002663
ADMINISTRATOR:SCHWARTZ, HEATHERFACILITY TYPE:
735
ADDRESS:5038 HUNTINGTON DRIVETELEPHONE:
(530) 364-2905
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 4CENSUS: 3DATE:
10/27/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Heather Schwartz, AdminTIME COMPLETED:
04:00 PM
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On 10/27/2021 Licensing Program Analyst (LPA) Misty Valencia arrived at the facility unannounced to conduct a case closure visit. LPA met with Heather Schwartz, Admin and explained the purpose of the visit. Prior to initiating the visit, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms; contacted licensee and completed a facility risk assessment. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N 95 Mask. Additional LPA was screen at the front door before entering the facility.

Case Closure:

Individual’s name:  Lisa Able


· Is individual working?:      no
· Comments: Admin reports that Lisa has not worked in the facility for over a year.
Date confirmation received: 10/27/2021    
Date of facility visit **:      10/27/2021
Civil penalties issued?:      No
Further Action required?:      No

No deficiencies are being cited as a result of todays visit. Copy of the report emailed to licensee and Admin.

SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Misty Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2021
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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