<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 292701043
Report Date: 08/09/2023
Date Signed: 08/14/2023 08:59:50 AM

Document Has Been Signed on 08/14/2023 08:59 AM - 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:ELEVATION TRUCKEEFACILITY NUMBER:
292701043
ADMINISTRATOR:BANKERT, JEANNE MFACILITY TYPE:
775
ADDRESS:10344 & 10356 DONNER PASS RD.TELEPHONE:
(530) 386-0890
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY: 30CENSUS: 11DATE:
08/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Jeanne Marliese Bankert, DirectorTIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 8/9/2023 LPA Tryon traveled to the facility to conduct an annual visit. LPA met with Director Jeanne Marliese Bankert. The program currently has 11 participants. Program currently has 4 staff. LPA toured the program with Mrs. Bankert including classrooms, art room, offices, space to rest/relax, bathrooms, etc. The program spends a lot of time out in the community.

The facility appears to be safe, clean, well-furnished and pleasant. Smoke detectors/carbon monoxide detectors are installed.

LPA reviewed the CARE Tool with Mrs. Bankert.

At this time, the program is in substantial compliance with the regulations.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1