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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340318217
Report Date: 08/03/2022
Date Signed: 08/03/2022 03:44:51 PM

Document Has Been Signed on 08/03/2022 03:44 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:CORINA CARE HOME 2FACILITY NUMBER:
340318217
ADMINISTRATOR:DRAGNEA, DUMITRUFACILITY TYPE:
735
ADDRESS:8744 SUPERB CIRCLETELEPHONE:
(916) 685-7049
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 4CENSUS: 3DATE:
08/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Dumitru DragneaTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) R. Campbell conducted an unannounced Case Management on this date and met with Administrator Dumitru Dragnea and explained the purpose of the visit. The case management visit pertains to needed improvements to areas where there were holes and continued maintenance of the backyard.

Since prior annual inspection, Dumitru Dragnea has added Exit signs for all entrances as requested by the Fire Marshall. He stated he planned to replace any doors that needed repair as well before he leaves the country in September for a medical procedure. The backyard continues to be clear of debris and meds are organized by clients name.

No deficiencies issued during the visit.

Exit interview conducted with Administrator Dumitru Dragnea and report was provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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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