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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700065
Report Date: 09/27/2023
Date Signed: 09/27/2023 11:15:42 AM

Document Has Been Signed on 09/27/2023 11:15 AM - 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:WILTON STABLESFACILITY NUMBER:
342700065
ADMINISTRATOR:TANYA BARRETOFACILITY TYPE:
735
ADDRESS:11119 MANN ROADTELEPHONE:
(916) 687-4548
CITY:WILTONSTATE: CAZIP CODE:
95693
CAPACITY: 4CENSUS: DATE:
09/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Kolu SokodoloTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Christina Valerio arrived to the facility unannounced to conduct a Plan of Correction Visit. LPA met with Administrator Kolu Sokodolo, and explained the purpose of the visit.

LPA observed the physical plant. LPA observed the facility to have recently cleaned up the front and backyard of the facility. LPA observed the patio with new outdoor furniture and an umbrella for shade. The inside of the home was redecorated to give a home-like feel and pictures of residents were observed in the common area of the home.

The facility was cited on 08/18/2023 for violating Title 22 Section 80074(c) and 80075(k)(1). On 09/14/23, LPA Valerio received an email from Administrator Kolu and Regional Manager Victor Cardona regarding the POCs. On 09/27/23, LPA Valerio observed the Transportation Van side mirror to be fixed and a new medication cabinet located in the common area. The medication cabinet was observed to be locked.

The deficiencies have been cleared. The facility was provided a Cleared POC Letter. An exit interview was held, and a copy of the report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2023
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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