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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002976
Report Date: 01/10/2023
Date Signed: 01/10/2023 05:36:28 PM


Document Has Been Signed on 01/10/2023 05:36 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:GOLDEN OAKS SENIOR LIVINGFACILITY NUMBER:
455002976
ADMINISTRATOR:WILLIAMS, KENNETHFACILITY TYPE:
740
ADDRESS:779 KERRYJEN CT.TELEPHONE:
(530) 604-4437
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:26CENSUS: 12DATE:
01/10/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Kenneth Williams, Stacey Miller, Melissa Johnson and Evelyn Lander-WilliamsTIME COMPLETED:
05:45 PM
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LPA Hiratsuka conducted this unannounced pre-licensing visit. This visit is unannounced because it's a change-of-ownership. LPA wore a surgical mask and observed all staff wearing surgical masks.

This facility has two buildings. The perimeter of this facility has a fence surrounding the property. The main gate is locked from the outside to prevent people from getting in but unlocked to allow people out. The facility does not require visitors to schedule visits unless there is an emergency situation. The building on the left has eight resident rooms: six rooms are shared and two private for a total of 14 residents. There are two resident rooms that share a doorway between them because one room has a designated exit to the outside. The door between the two rooms cannot be blocked due to the one room having the fire exit. Some of the other rooms have exits to the outside. It also has a dining room, the kitchen for both buildings, sitting area, staff break room, and three full bathrooms.
The building on the right has eight resident rooms: two shared and six private for a total of ten residents. Some of the resident rooms have exits to the outside. This building also has three full common bathrooms, and kitchenette area that does not have an oven/stove, two sitting areas, and an office.

The courtyard has several locked storage units.

Component III orientation was waived due to Applicant owning multiple facilities.

Multiple topics were discussed.

This facility meets regulations. LPA is going to submit this report to the application specialist.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2023
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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