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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 286804025
Report Date: 06/26/2024
Date Signed: 06/26/2024 03:31:02 PM


Document Has Been Signed on 06/26/2024 03:31 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:ZEALCARE HOMEFACILITY NUMBER:
286804025
ADMINISTRATOR:MARTINEZ, MADONNA GRACEFACILITY TYPE:
740
ADDRESS:2504 REDWOOD RD.TELEPHONE:
(707) 258-9348
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:6CENSUS: DATE:
06/26/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Madonna Martinez, Licensee/AdministratorTIME COMPLETED:
03:30 PM
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A non-compliance conference was conducted today in the Santa Rosa Regional Office. Present in the meeting: Regional Manager, Carla Nuti-Martinez, Licensing Program Manager, Bethany Moellers, Licensing Program Analyst, Julie Florio, and Facility Licensee/Administrator, Madonna Martinez. An informal office meeting was conducted on 6/12/2024, to discuss identified compliance concerns, not limited to clearing POCs. During this meeting, Licensee agreed to submit documents to clear POCs by close of usiness 6/14/2024 and failed to do so. The purpose of today's meeting is to review ongoing compliance concerns.

This non-compliance conference is being conducted to discuss concerns identified by community care licensing in regards to the operation of Zealcare Home, 286804025 and Magnolia Gold Home Care, 486803895. Areas of noncompliance not limited to below were discussed:

  • Administrator Duties and Qualifications
  • Active Administrator in place for facility oversight per regulation
  • Clearing POCs
  • Reporting Requirements
  • Timely response to CCL when communication is engaged


LIcensee was informed of Technical support program and agrees to engage in services.

No deficiencies sited during this noncompliance conference.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Julie FlorioTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/26/2024
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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