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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002952
Report Date: 12/15/2022
Date Signed: 12/15/2022 11:00:57 AM


Document Has Been Signed on 12/15/2022 11:00 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
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926



FACILITY NAME:SHARON'S CARE HOMEFACILITY NUMBER:
455002952
ADMINISTRATOR:BERRY, CASSIEFACILITY TYPE:
740
ADDRESS:3544 LAKE FOREST DRIVETELEPHONE:
(530) 953-7292
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:6CENSUS: 5DATE:
12/15/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Cassie Berry - LicenseeTIME COMPLETED:
11:15 PM
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12/15/2022 10:00 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility to conduct their scheduled pre-licensing inspection. Prior to initiating the annual inspection, 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. LPA ensured they applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: N95 mask, gloves. LPA met with licensee Cassie Berry and administrator Christopher Bell and explained the purpose of the visit.

Comp 3 was presented by LPA to licensee and administrator during the visit.

The fire marshal has approved the fire safety inspection request. The facility is licensed for a total capacity of 6 non-ambulatory residents.

The inside of the facility was observed to be in good condition and repair. The facility has four (4) bedrooms, and two (2) bathrooms. LPA observed 1 dining table with proper seating for residents. LPA observed 3 recliners and 1 easy chair with ottoman in the common area.

The hot water registered at 108 F degrees which met the requirement for licensing within a range of 105 - 120 degrees F.

Food storage meets Title 22 regulation requirements. Plates, utensils, pots, and pans were in place during the inspection. Dishwasher, stove, microwave and refrigerator were all present and working.

Continued on LIC809-C
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Rebecca KnightTELEPHONE: (530) 356-2841
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CHICO - RESIDENTIAL, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: SHARON'S CARE HOME
FACILITY NUMBER: 455002952
VISIT DATE: 12/15/2022
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The facility has two fully charged fire extinguishers which were inspected by the fire marshall on February /2022. LPA observed smoke alarms and carbon monoxide detectors fully functioning.

Bedrooms were observed to have furniture as required by Title 22 Regulations. All beds were made up with linens and bedspreads. Each bedroom has ample storage. The facility has a linen closet which contains sheets, pillowcases, towels and face cloths. Bathrooms were observed to be in good repair.



The facility has a locked medication cabinet which is located in the dining room.

Storage and lighting are adequate in the home. Cleaning supplies and toxins are locked up in a cabinet in the kitchen under the sink. Also locked in the kitchen are knives. Washer and dryer observed in place and ready for use.

Resident and staff files are locked in the facility office.

The back yard has a shaded structure and table and chairs for residents to use.

Covid 19 preparations are in place.

The applicants have passed the pre-licensing portion of the application process. LPA will contact the Central Application Bureau.

No deficiencies according to CCR Title 22, Division 6. Exit Interview and copy of report was provided to the licensee.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Rebecca KnightTELEPHONE: (530) 356-2841
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
LIC809 (FAS) - (06/04)
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