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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317005948
Report Date: 09/29/2022
Date Signed: 09/29/2022 12:40:26 PM

Document Has Been Signed on 09/29/2022 12:40 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:ABLEFACILITY NUMBER:
317005948
ADMINISTRATOR:POURARIAN, AMITISFACILITY TYPE:
775
ADDRESS:8200 SIERRA COLLEGE DTELEPHONE:
(916) 276-6777
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 30CENSUS: 0DATE:
09/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Amitis PourarianTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Sarena Keosavang arrived to the facility Able - 317005948 to conduct a Required- 1 Year inspection. LPA met with Licensee, Amitis Pourarian, and explained the purpose of the visit.

LPA notes that the license is still current and active. However, the facility is not in operation at this time as a Day Program.

LPA toured the facility. LPA and Licensee discussed the vendorization process involving ALTA Regional Center. LPA notes that the Licensee is not currently vendorized, will maintain licensure of the space and will update CCLD with any changes.

No deficiencies issued.

Exit interview. Copy of report provided to facility representative.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Sarena Keosavang
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2022
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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