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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920173
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:35:07 PM

Document Has Been Signed on 01/07/2025 12:35 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:SNR CARE HOMEFACILITY NUMBER:
315920173
ADMINISTRATOR/
DIRECTOR:		CASCASAN, STEPHANIE BALTARFACILITY TYPE:
740
ADDRESS:8248 SCHELLHOUS DRIVETELEPHONE:
(347) 946-5523
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6CENSUS: 0DATE:
01/07/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Stephanie Baltar Cascasan, AdministratorTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Administrator, Stephanie Baltar Cascasan, to conduct a Pre- Licensing visit. The facility has a fire clearance for three (3) non-ambulatory residents and three (3) bedridden residents with a hospice waiver for two (2) residents. Administrator has an active certificate (#7028782740 with expiration date 8/14/2026).

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. There are four (4) bedrooms and two (2) bathrooms for resident use. Bathrooms were in sanitary condition and properly maintained. Hot water temperature was observed to be 116.5 degrees F. LPA observed facility has the ability to prepare and store food, to lock away cleaning products and other toxins, and lock medications to make inaccessible to residents. LPA observed smoke detectors and carbon monoxide detectors to be operational in the care home. First aid kit is maintained and ready for emergency use.

Component III was completed. Application is pending and LPA will forward findings to the Centralized Application Bureau (CAB) for final review and approval. CAB will further contact applicant on final status of application. A copy of this report was provided to the facility. Exit interview conducted.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Michael Hood
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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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