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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 236801775
Report Date: 01/26/2023
Date Signed: 01/26/2023 02:59:14 PM

Document Has Been Signed on 01/26/2023 02:59 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:EQUINOX CARE FACILITY LLCFACILITY NUMBER:
236801775
ADMINISTRATOR:AJEL, AGNESFACILITY TYPE:
740
ADDRESS:38281 S HWY 1TELEPHONE:
(707) 884-4061
CITY:GUALALASTATE: CAZIP CODE:
95445
CAPACITY: 9CENSUS: 8DATE:
01/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Leene MarzoTIME COMPLETED:
03:15 PM
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At approximately 1:30PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a case management visit in regards to the recent winter storms. LPA met with Caregiver Leene Marzo and toured the facility and grounds. The facility lost power during the storms but has a generator to supply power when the utility is out. There were no trees that fell close to the home and there were no other issues.
LPA previously spoke with Administrator regarding an updated Fire Clearance and LPA was informed that the Fire Marshall has not yet made the inspection. LPA will follow up the the Fire Marshall.

No citations issued during this visit.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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