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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700240
Report Date: 04/23/2024
Date Signed: 04/23/2024 12:25:58 PM


Document Has Been Signed on 04/23/2024 12:25 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:ROYAL PALMS CARE HOMEFACILITY NUMBER:
342700240
ADMINISTRATOR:DANIELA PODARFACILITY TYPE:
740
ADDRESS:8675 PHOENIX AVETELEPHONE:
(916) 477-1554
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 6DATE:
04/23/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Denisa Crisan, Acting AdministratorTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the facility and met with Acting Administrator, Denisa Crisan, to obtain a signature relative to amending a report for an inspection conducted on 4/04/2024. LPA spoke with Licensee, Daniela Podar, via telephone, who gave permission to have Acting Administrator sign report.

Signature was obtained for amended document during visit.

Exit interview was conducted. A copy of this report and was provided. Signature on these forms acknowledges receipt of these documents.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024
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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