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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001696
Report Date: 02/27/2023
Date Signed: 02/27/2023 01:16:59 PM

Document Has Been Signed on 02/27/2023 01:16 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:LA HONDA GUEST HOMEFACILITY NUMBER:
347001696
ADMINISTRATOR:TORRES, MARGARITAFACILITY TYPE:
740
ADDRESS:3940 LA HONDA WAYTELEPHONE:
(916) 944-8909
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 6CENSUS: DATE:
02/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Neal and Margie TorresTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Cassie Yang arrived at the facility unannounced on 02/27/2023 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Administrator, Margie Torres, and explained the purpose of the visit.

LPA and Administrator toured the interior of the facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, four (4) resident bedrooms, three (3) bathrooms, kitchen, laundry room and garage. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time.

LPA discussed balance fees with Administrator. LPA observed the license posted to be outdated, LPA informed Administrator a new license will be sent to the facility.

At this time, LPA requested for Licensee to submit the following requested documents to LPA by 03/6/2023:
  • LIC 308 Designation of Administrative Responsibility
  • Administrator Certificate
  • Current Liability Insurance
  • LIC 500 Personnel Report

No deficiencies are being cited as a result of todays inspection.

Exit interview conducted and copy of report was emailed to Administrator.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2023
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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