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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002774
Report Date: 03/05/2024
Date Signed: 03/05/2024 02:41:09 PM

Document Has Been Signed on 03/05/2024 02:41 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:ROSELEAF SENIOR DAY CENTER - CHICOFACILITY NUMBER:
045002774
ADMINISTRATOR:BINGHAM, DIANIAFACILITY TYPE:
775
ADDRESS:2770 SIERRA LADERATELEPHONE:
(559) 970-1240
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: 60CENSUS: 0DATE:
03/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Administrator TIME COMPLETED:
02:45 PM
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03/05/2024, Licensing Program Analyst (LPA) Jaynae Boyles arrived at the facility unannounced to conduct a Required-1 Year Inspection.
It should be noted that although licensed, the day program has not been operating since the start of the pandemic. The day program normally operates in the Roseleaf Gardens facility
(45002775) but was not in operation at the time of this inspection.

No deficiencies are being cited as a result of todays inspection. Exit interview conducted and copy of report was provided to Executive Director.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Jaynae Boyles
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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