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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700419
Report Date: 04/08/2024
Date Signed: 04/08/2024 01:33:27 PM

Document Has Been Signed on 04/08/2024 01:33 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:TIMELESS TREASURESFACILITY NUMBER:
342700419
ADMINISTRATOR/
DIRECTOR:		BRAR, RUPNEETFACILITY TYPE:
740
ADDRESS:3446 BECERRA WAYTELEPHONE:
(916) 359-1355
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY: 6CENSUS: 4DATE:
04/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:50 PM
MET WITH:AARON FINTEL - DIRECT CARE STAFFTIME VISIT/
INSPECTION COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Ruth Wallace conducted unannounced Plan of Correction visit. LPA met with direct care staff and explained purpose of visit.

LPA conducted annual inspection on 4/6/2024 and cited A citation for volunteer (1) not obtaining fingerprint clearance before volunteering at facility. Plan of Correction (POC) was due on 4/7/204 and not received within the 24 hour period required for A citation.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following repeat deficiency is being cited. See LIC421FC for continuation of a daily penalty of $100.00 that was first assessed on 4/6/24.

Exit interview conducted with direct care staff. Copy of reports left at facility.






SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Ruth Wallace
LICENSING EVALUATOR SIGNATURE: DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/08/2024
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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