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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045920283
Report Date: 05/05/2026
Date Signed: 05/05/2026 02:28:44 PM

Document Has Been Signed on 05/05/2026 02:28 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:LIGHTHOUSE AT CHICO, LLC, THEFACILITY NUMBER:
045920283
ADMINISTRATOR/
DIRECTOR:		CORPUS, ILONAFACILITY TYPE:
740
ADDRESS:855 BRUCE ROADTELEPHONE:
(530) 566-1800
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: 120CENSUS: 41DATE:
05/05/2026
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Ilona Corpus, Executive DirectorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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On May 5, 2026, Licensing Program Analyst (LPA) Kayla Adkison, arrived at the facility unannounced to conduct a Required Annual Inspection. LPA met with Ilona Corpus, Executive Director (ED), and explained the purpose of the visit. During the inspection, there were 41 residents and seven (7) staff providing direct care. LPA observed residents watching television in their rooms and enjoying a Cinco de Mayo themed lunch during the inspection. The facility was in the process of preparing for a Cinco De Mayo celebration planned for the afternoon.

LPA and ED toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to: common areas, activity room, med room, eleven (11) resident rooms with full bathrooms, courtyard, kitchen, and storage areas. LPA observed each bedroom to have the required furnishings and working lights. LPA observed the facility to be at a comfortable temperature. There were various activities available for client recreation. LPA observed a calendar of activities posted for residents to view, as well as printed copies for resident rooms.

Facility has a 2-day perishable and a 7-day non-perishable amount of food. All residents requiring a special diet are posted for kitchen staff to review. LPA observed a full menu posted for residents to review. LPA observed all medications and sharps to be locked away and inaccessible to clients in care. During a tour of the memory care side of the facility, LPA observed a one (1) can of disinfectant spray in an unlocked cabinet in the common area. Staff removed the item and locked the cabinet during the inspection. LPA observed a complete First Aid kit located in the med room.

LPA observed (3) three fire extinguishers and smoke detectors throughout the facility, which were last inspected in October 2025. The facility is conducting emergency disaster drills monthly with the last drill being documented in February 2026.

Continued on LIC 809-C
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Kayla Adkison
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LIGHTHOUSE AT CHICO, LLC, THE
FACILITY NUMBER: 045920283
VISIT DATE: 05/05/2026
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LPA reviewed a total of six (6) resident files. One (1) resident file was missing proof of a negative tuberculosis exam. LPA observed seven (7) staff files which contained all the required documentation. All staff are fingerprint cleared and associated to the facility. All staff training is documented and in compliance with Title 22 regulations.

LPA requested copies of the most recent LIC 500, current liability insurance, and the facility's reviewed emergency disaster plan be submitted via email.

Deficiencies are being cited from the California Code of Regulations, Title 22, and are recorded on the attached LIC 809-D. Failure to correct the deficiencies may result in civil penalties. Exit interview conducted. A copy of this report and Appeal Rights were provided, via email, to Executive Director, Ilona Corpus, via email.
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Kayla Adkison
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/05/2026 02:28 PM - It Cannot Be Edited


Created By: Kayla Adkison On 05/05/2026 at 01:06 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LIGHTHOUSE AT CHICO, LLC, THE
FACILITY NUMBER: 045920283

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/05/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
87309(a)
Storage Space and Access
(a) Except as specified in subsection (b), the licensee shall ensure that disinfectants, cleaning solutions, poisonous substances, knives, matches, tools, sharp objects, and other similar items which could pose a danger to residents are in locked storage and are not left unattended if outside the locked storage.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that one (1) disinfectant cleaning spray was observed in an unlocked cabinet in a common area of the memory care side of the facility, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/22/2026
Plan of Correction
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LPA observed staff remove the item and lock the cabinet during the inspection.

Licensee/Executive Director shall conduct an in-service training for all staff on the importance of the regulation cited. ED shall submit staff sign in sheet to LPA by end of business on May 22, 2026.
Type B
Section Cited
CCR
87458(c)(1)(A)
Medical Assessment
(c) The medical assessment shall include, but not be limited to: (1) A physical examination of the resident indicating the licensed medical professional's diagnosis or diagnoses and results of an examination for all of the following: (A) Communicable tuberculosis.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that one (1) out of six (6) residnet files reviewed were missing proof of a negativce tuberculosis exam, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/02/2026
Plan of Correction
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License/Executive Director shall submit proof of negative tuberculosis test for (1) one resdient (R1) by end of business on June 2, 2026
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lauren Crocker
NAME OF LICENSING PROGRAM MANAGER:
Kayla Adkison
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/05/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2026


LIC809 (FAS) - (06/04)
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