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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700012
Report Date: 03/11/2025
Date Signed: 03/11/2025 12:23:36 PM

Document Has Been Signed on 03/11/2025 12:23 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:TWIN RIVERS AT NATOMASFACILITY NUMBER:
342700012
ADMINISTRATOR/
DIRECTOR:		GENAYA REESEFACILITY TYPE:
740
ADDRESS:421 SAN JUAN ROADTELEPHONE:
(916) 216-3058
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY: 48TOTAL ENROLLED CHILDREN: 0CENSUS: 36DATE:
03/11/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:05 AM
MET WITH:Sita VadarevuTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On March 11, 2025, Licensing Program Analysts (LPAs) Cassie Yang and Kerry Hiratsuka arrived unannounced at the facility to conduct a case management visit regarding a deficiency observed. LPAs met with Administrator and explained the purpose of the visit.

During today's visit, LPAs and Administrator discussed the incident that occurred on January 28, 2025. Based on file review, LPAs observed that S1 is not fingerprint cleared as a criminal record exemption is needed. File review of Guardian website revealed S1's fingerprint clearance is "in process" since November 25, 2024. Administrator stated S1 was working at the facility for two to three months prior the incident. S1 is not working at the facility at this time until cleared for exemption.

Please see LIC 809-D. Civil penalty was assessed.

Exit interview and a copy of the report and appeal rights was provided.
Anthony PerezTELEPHONE: (323) 485-4915
Cassie YangTELEPHONE: (916) 201-1928
DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 03/11/2025 12:23 PM - It Cannot Be Edited


Created By: Cassie Yang On 03/11/2025 at 11:59 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TWIN RIVERS AT NATOMAS
FACILITY NUMBER: 342700012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
03/12/2025
Section Cited

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87411 Personnel Requirements - General (g) Prior to employment or initial presence in the facility, all employees and volunteers subject to a criminal record review shall: (1) Obtain a California clearance or a criminal record exemption as required by law or Department regulations
This requirement is not met as evidenced by:
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Based on file review, Licensee did not comply to section cited above as S1 was working at the facility when S1 did not obtained an exemption to work at the facility, which poses an immediate risk for residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Anthony Perez
TELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME:Cassie Yang
TELEPHONE: (916) 201-1928
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
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