315001843-3-11-2025-59-AS-CMIN-DENRPK-20250311131205

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 315001843
Report Date: 03/11/2025
Date Signed: 03/11/2025 01:12:11 PM

Document Has Been Signed on 03/11/2025 01:12 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:	BROOKDALE ROSEVILLE		FACILITY NUMBER:	315001843
ADMINISTRATOR/ DIRECTOR:	ABIGAIL VUE		FACILITY TYPE:	740
ADDRESS:	1 SOMER RIDGE DR		TELEPHONE:	(916) 773-5955
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95661
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 0	CENSUS: 18	DATE:	03/11/2025
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:50 AM
MET WITH:	Abigail Vue, Executive Director		TIME VISIT/ INSPECTION COMPLETED:	01:25 PM

NARRATIVE

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Licensing Program Analysts (LPAs) Cassandra Mikkelson and Cheyenne Ratajczak met with Executive Director (ED) Abigail Vue to discuss two incident reports that had been sent to CCLD.

LPAs conducted interviews, toured facility and collected pertinent documents related to each incident report for review.

At this time, no deficiencies are being cited.

LPAs will return if further follow up is needed.

Exit interview conducted, copy of this report was left at the facility.

Laura Munoz	TELEPHONE: (916) 709-6317
Cassandra Mikkelson	TELEPHONE: (916) 709-6830
	DATE: 03/11/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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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