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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700146
Report Date: 06/17/2021
Date Signed: 06/17/2021 02:43:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:DAYLIGHT-HINCKLEYFACILITY NUMBER:
312700146
ADMINISTRATOR:SHEYNIS, DIANAFACILITY TYPE:
740
ADDRESS:141 HINCKLEY CTTELEPHONE:
(916) 936-6766
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:6CENSUS: 0DATE:
06/17/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Diana Sheynis, AdministratorTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Michael Hood met with Administrator, Diana Sheynis, to conduct an inspection proceeding the closure of the facility. A Notice of Facility Closure was received by the Regional Office with a facility closure date of 6/17/2021.

LPA observed interior/exterior of the facility, including front and back yard, shed, living room, dining room, kitchen, garage, pantry, laundry room, staff room, 3 bathrooms, and 6 bedrooms. LPA observed that there were no residents at the facility.

A copy of the license was obtained by the LPA during the visit. LPA informed Licensee that facility will be closed in the department's system effective 6/17/2021.

Facility evicted 3 residents during period of facility closure. LPA received a copy of the eviction notices for residents R1, R2, and R3 on 6/11/2021. All eviction notices are dated 5/21/2021. Eviction notices state the following:

“You agreed on the Date of June 1st, 2021 as a moving date, after I spoke to you today. This is the date that we have been waiting to set. Please acknowledge that I have not given you an official 60 day eviction notice, since we have verbally agreed on the above mentioned date.”

** Report continued on 809-D **
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME: DAYLIGHT-HINCKLEY
FACILITY NUMBER: 312700146
VISIT DATE: 06/17/2021
NARRATIVE
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All three notices did not include resources available to assist in identifying alternative housing and care options, including public and private referral services and case management organizations, or information about the resident's right to file a complaint with the department regarding the eviction, with the name, address, and telephone number of the nearest office of community care licensing and the State Ombudsman.

As a result of today's visit, a deficiency is being cited in regards to eviction notices per California Code of Regulations, Title 22, on 809-D.

Exit interview was conducted with Administrator. A copy of this report and appeal rights were provided. The Administrator’s signature on these forms acknowledges receipt of these documents.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926

FACILITY NAME: DAYLIGHT-HINCKLEY
FACILITY NUMBER: 312700146
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2021
Section Cited

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87224 Eviction Procedures (d) The licensee shall set forth in the notice to quit the reasons relied upon for the eviction with specific facts to permit determination of the date, place, witnesses, and circumstances concerning those reasons. This requirement is not met as evidenced by:
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Based on eviction notices submitted to CCLD, the facility did not ensure residents received pertinant information in writing upon eviction from the facility, which posed a potential health, safety, and personal rights risk to the residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 06/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/17/2021
LIC809 (FAS) - (06/04)
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