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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920023
Report Date: 09/26/2024
Date Signed: 09/26/2024 02:05:14 PM


Document Has Been Signed on 09/26/2024 02:05 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:DAD'S PLACE, INC.FACILITY NUMBER:
315920023
ADMINISTRATOR:MURRAY, KATHERINE S.FACILITY TYPE:
740
ADDRESS:8100 HORSESHOE BAR RD.TELEPHONE:
(530) 718-0932
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:6CENSUS: 6DATE:
09/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Valentina Petylo, StaffTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Melissa Parks arrived on Thursday September 26, 2024 to conduct the unannounced annual inspection. Due to scheduling conflicts with the Administrator, LPA will return at a later date to continue/complete the inspection.

Exit interview conducted. A copy of this report was emailed to the Administrator.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa ParksTELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:
DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/26/2024
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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