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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515000486
Report Date: 07/18/2024
Date Signed: 07/18/2024 03:49:19 PM

Document Has Been Signed on 07/18/2024 03:49 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CHESTNUT COMMONSFACILITY NUMBER:
515000486
ADMINISTRATOR/
DIRECTOR:		AMANDA SCHNEPELFACILITY TYPE:
735
ADDRESS:911 CHESTNUT ST. STE. ATELEPHONE:
(530) 674-3482
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY: 15CENSUS: 15DATE:
07/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:Amanda SchnepelTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA toured with Administrator Amanda Schnepel.
This facility is made up of three buildings. Two of the three buildings have a second floor. All apartments exit to the outside. The apartments are either one or two bedroom apartments with kitchenettes and full bathrooms. There is a laundry room that is attached to one of the buildings. There is one building that has the main public entrance, a common bathroom, the kitchen, dining, and a common area. The property is surrounded by a fence. One apartment has a door leading outside the fence.

Several resident and staff files were reviewed.

Multiple of topics were discussed.

No deficiencies cited.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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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