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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
306006192
Report Date:
11/13/2024
Date Signed:
11/13/2024 02:29:34 PM
Document Has Been Signed on
11/13/2024 02:29 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
,
770 THE CITY DR., SUITE 7100
ORANGE
,
CA
92868
FACILITY NAME:
VIOLA HOMES ESTATE
FACILITY NUMBER:
306006192
ADMINISTRATOR/
DIRECTOR:
SNETTER, MIATTA
FACILITY TYPE:
735
ADDRESS:
15770 AZALEA WAY
TELEPHONE:
(323) 304-4620
CITY:
WESTMINSTER
STATE:
CA
ZIP CODE:
92683
CAPACITY:
4
CENSUS:
3
DATE:
11/13/2024
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:
Gazel Montes
TIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced case management visit to follow up on an eviction notice submitted 10/30/2024. LPA knocked on door with no response. LPA called Licensee who stated there was no staff available at that time due to medical appointments. LPA advised would come back later in the day.
Report provided to facility.
SUPERVISORS NAME
:
Alisa Ortiz
LICENSING EVALUATOR NAME
:
Kimberly Lyman
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/13/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/13/2024
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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