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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002835
Report Date: 09/28/2021
Date Signed: 09/28/2021 02:45:39 PM

Document Has Been Signed on 09/28/2021 02:45 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:PREMIER SOLUTIONSFACILITY NUMBER:
455002835
ADMINISTRATOR:LARMOUR, DEBBIEFACILITY TYPE:
775
ADDRESS:2875 CHURN CREEK RDTELEPHONE:
(530) 375-0528
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY: 35CENSUS: 21DATE:
09/28/2021
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Sabrina Gill; Program DirectorTIME COMPLETED:
02:45 PM
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On 9/2/21 at 11:45 AM, Licensing Program Analyst (LPA) Cheng conducted an unannounced post licensing visit and met with Administrator Cindy Davis. 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 Administrator 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: surgical mask and gloves. Additionally, LPA was screened by staff.

LPA Cheng conducted the post licensing visit simultaneously with facility's required 1-year inspection. All notes and observations are indicated on facility's inspection conducted on 9/28/21.

No deficiencies were observed.

Exit interview conducted and a copy of report was given.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Pheej Cheng
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2021
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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