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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312701032
Report Date: 10/14/2024
Date Signed: 10/14/2024 12:51:11 PM

Document Has Been Signed on 10/14/2024 12:51 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:AMI HOUSING, INC.FACILITY NUMBER:
312701032
ADMINISTRATOR/
DIRECTOR:		JENNIFER PRICEFACILITY TYPE:
735
ADDRESS:1720 LILAC LANETELEPHONE:
(530) 878-5088
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 15CENSUS: 14DATE:
10/14/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Jennifer Price, CEO by telephone; Christina Kay, House MonitorTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 10/14/2024 LPA Tryon visited the facility to do a case management visit regarding a notice that was issued on October 8, 2024 to resident R1. The notice states that "Notice is hereby given that within three (3) days of service on you of this notice you are required to perform the covenant(s) specified below or quit and deliver up possession of the above described premises, to AMI Housing, Inc., or the undersigned, his authorized agent. Failing this, legal proceedings will be commenced against you to recover possession of said premises and rents and damages and all court costs and attorney's fees allowed by law."

LPA met with staff who contacted Jennifer Price by phone. LPA explained the reason for the visit. Ms. Price approved staff to sign and receive the documents.

The Dept. finds this to be an illegal eviction. Title 22 Section 80068.5 states in part:
Eviction Procedures (b) The licensee shall obtain prior written approval from the Department to evict the client upon three (3) days written notice to quit and upon a finding of good cause."

The following deficiency is cited as per Title 22 Section 80068.5. This report was shared with staff at the facility. Appeal rights were provided. Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/14/2024 12:51 PM - It Cannot Be Edited


Created By: Todd Tryon On 10/14/2024 at 12:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: AMI HOUSING, INC.
FACILITY NUMBER: 312701032

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/15/2024
Section Cited
CCR
80068.5(b)

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The licensee shall obtain prior written approval from the Department to evict the client upon three (3) days written notice to quit.
The facility did not obtain Department permission prior to serving the notice.
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The facility will immediately notify the affect resident, and if applicable, their representative, both verbally and in writing, that the 3 Day Notice to Perform Covenant or Quit is unlawful and has been rescinded. The facility shall send proof of correction by COB 10/15/2024.

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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:Troy Ordonez
LICENSING EVALUATOR NAME:Todd Tryon
LICENSING EVALUATOR SIGNATURE:
DATE: 10/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/14/2024


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