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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700311
Report Date: 03/07/2024
Date Signed: 03/07/2024 11:11:58 AM


Document Has Been Signed on 03/07/2024 11:11 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:ABOUTLIFE CARE FACILITYFACILITY NUMBER:
312700311
ADMINISTRATOR:DANU, TATIANAFACILITY TYPE:
740
ADDRESS:2705 LUPINE CTTELEPHONE:
(916) 844-8540
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:6CENSUS: 6DATE:
03/07/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Tatiana DanuTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Melissa Parks arrived on Thursday March 7, 2024 to conduct the a case management visit to ensure the facility is following the stipulation and waiver.

LPA Parks reviewed the probation binder. LPA confirmed with the Administrator that facility is complying with probation conditions. LPA toured the home and all door alarms were tested. The home is well maintained and residents appeared to have needs met.

No deficiencies cited. Exit interview conducted. A copy of this report was provided to the Administrator.

SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa ParksTELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:
DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/07/2024
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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