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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002883
Report Date: 07/31/2023
Date Signed: 07/31/2023 02:21:34 PM

Document Has Been Signed on 07/31/2023 02:21 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME:CELESTIAL CARE ADULT FACILITY, LLCFACILITY NUMBER:
315002883
ADMINISTRATOR:YAPDIANGCO, CHARITYFACILITY TYPE:
735
ADDRESS:4136 WEATHERVANE WAYTELEPHONE:
(530) 782-3953
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 4CENSUS: 0DATE:
07/31/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Charity Yapdiangco, AdministratorTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct annual inspection. LPA met with Charity Yapdiangco during today's inspection.

Currently there are no clients at the facility. LPA entered the home and observed no clients are living at the facility. Administrator stated they are still working on vendorization for the home.

No deficiencies cited during today's inspection.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2023
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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