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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700311
Report Date: 05/21/2024
Date Signed: 05/21/2024 02:40:11 PM


Document Has Been Signed on 05/21/2024 02:40 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
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:
05/21/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Tatiana DanuTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Melissa Parks arrived on Tuesday May 21, 2024 to conduct the a case management visit to ensure the facility is following the stipulation and waiver.

LPA reviewed 2 new resident binders. LPA Parks reviewed the probation binder. LPA confirmed with the Administrator that facility is complying with probation conditions.

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: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/21/2024
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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