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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340317699
Report Date: 04/14/2023
Date Signed: 04/14/2023 01:31:05 PM

Document Has Been Signed on 04/14/2023 01:31 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:PRAISE CARE HOMEFACILITY NUMBER:
340317699
ADMINISTRATOR:ARTURO MERCADOFACILITY TYPE:
735
ADDRESS:4600 PARKER AVENUETELEPHONE:
(916) 803-5864
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY: 36CENSUS: 33DATE:
04/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Arturo MercadoTIME COMPLETED:
01:45 PM
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On April 14, 2023 At 1:15 PM, Licensing Program Analysts (LPA) Avelina Martinez and LPA Pang Lee arrived unannounced to deliver an Order of Exclusion for a staff member. LPAs Martinez and Lee met with Arturo Mercado and explained the purpose of today's visit.

LPAs Martinez and Lee were informed by Arturo Mercado, the staff member named in the Order of Exclusion, Maricar Venegas no longer works at the facility.

LPAs Martinez and Lee provided Arturo Mercado with a copy of the Order and explained that Maricar Venegas is not allowed in the facility effective immediately.

Exit interview was held, and a copy of this report and Immediate Exclusion letter were provided to the facility.
SUPERVISORS NAME: Czarrina A Camilon-Lee
LICENSING EVALUATOR NAME: Avelina Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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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