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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700311
Report Date: 09/20/2023
Date Signed: 09/20/2023 02:52:41 PM


Document Has Been Signed on 09/20/2023 02:52 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:SCUTARU, ELIZAVETAFACILITY TYPE:
740
ADDRESS:2705 LUPINE CTTELEPHONE:
(916) 844-8540
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY:6CENSUS: 6DATE:
09/20/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Tatiana DanuTIME COMPLETED:
03:00 PM
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On 11/30/22, Licensing Program Analyst (LPA) Kevin Mknelly, met with designee, Tatiana Danu.

The purpose of this inspection was to conduct a health and safety check related to licensee's increased monitoring during probation.

LPA and Tatiana discussed process to designate a new Administrator, resolving a Admin renewal and the 18 month period where the probation length may be reconsidered.

LPA confirmed that licensee met all current probation conditions. LPA toured the home. The home is well maintained and residents appeared to have needs met. Alarms and staffing meet the facilities plan of correction for the incident that lead to the probation.

As a result of this inspection, no deficiencies were found.

Report reviewed and copy provided.

SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:
DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/20/2023
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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