Community Care Licensing

Document Has Been Signed on 08/19/2024 12:39 PM - It Cannot Be Edited

FACILITY NAME:	TIMELESS TREASURES		FACILITY NUMBER:	342700419
ADMINISTRATOR/ DIRECTOR:	BRAR, RUPNEET		FACILITY TYPE:	740
ADDRESS:	3446 BECERRA WAY		TELEPHONE:	(916) 359-1355
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95821
CAPACITY: 6		CENSUS: 4	DATE:	08/19/2024
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Aarpn Fintel		TIME VISIT/ INSPECTION COMPLETED:	12:37 PM

NARRATIVE

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On 8/19/2024, Licensing Program Analyst Holly Williams and LPM Czarrina Camilon-Lee conducted an unannounced visit to conduct a case management visit to follow up on the facility profile information. The facility alternate mobile number was not working and the facility phone number, the voicemail was full. Staff Aaron Fintel stated the voicemail's were full and cleared the voicemail box. LPM Camilon-Lee informed Fintel that the annual fee's have not been paid. Which will need to be paid as soon as possible. We advised Fintel on the licensing process and that the licensing application could take 90 days and advised Fintel about the licensing form LIC 281 for change of ownership .During todays visit the LPA Williams provided LIC 311F named Records to be maintained at the facility. During todays visit LPA Williams also discussed the parameters of volunteers and provided Title 22 87355 (2)(b) regarding volunteer requirements. LPA contacted the licensee on 8/16/24 and asked for administrator paperwork, since Rupneet is no longer the Administrator of the facility. The following forms will need to be submitted for review. Licensee to provide with in 5 days: LIC 200 LIC 501 Aaron Fintel Health Screening LIC 500 Schedule Update the facility email to Aaron Fintel email Death report LIC 610 E Proof of annual fee's paid The following deficiencies are being cited. See LIC 809-D. Appeal rights provided. Exit interview with staff Aaron Fintel conducted.

SUPERVISORS NAME: Czarrina A Camilon-Lee LICENSING EVALUATOR NAME: Holly Williams LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2024

Link to Parent Document Below:

FACILITY NAME: TIMELESS TREASURES	FACILITY NUMBER: 342700419
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/19/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/23/2024 Section Cited CCR 87405(a)	1 2 3 4 5 6 7	87405 Administrator - Qualifications and Duties(a) All facilities shall have a qualified and currently certified administrator. Based on interview with the licensee and staff there is no current certified administrator in the facility.	1 2 3 4 5 6 7	Licensee to provide to CCL with in 5 days: LIC 200 LIC 501 Aaron Fintel Health Screening LIC 500 Schedule Update the facility email to Aaron Fintel email Death report LIC 610 E Proof of annual fee's paid
	8 9 10 11 12 13 14		8 9 10 11 12 13 14
Type B 08/23/2024 Section Cited CCR87156(2)(e)	1 2 3 4 5 6 7	(e) The failure of a licensee to pay all applicable and accrued fees and civil penalties shall constitute grounds for denial or forfeiture of a license.	1 2 3 4 5 6 7	Licensee agrees to pay all outstanding licensing fees by close of business Friday 8/23/24. Submit proof of correction to LPA by due date. Holly.williams@dss.ca.gov
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

SUPERVISOR'S NAME: Czarrina A Camilon-Lee LICENSING EVALUATOR NAME: Holly Williams LICENSING EVALUATOR SIGNATURE: DATE: 08/19/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/19/2024