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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
342700419
Report Date:
04/25/2024
Date Signed:
04/25/2024 01:17:02 PM
Document Has Been Signed on
04/25/2024 01:17 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 SOUTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
TIMELESS TREASURES
FACILITY NUMBER:
342700419
ADMINISTRATOR:
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:
04/25/2024
TYPE OF VISIT:
POC
UNANNOUNCED
TIME BEGAN:
11:30 AM
MET WITH:
Aaron Fintel
TIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a plan of correction visit. LPA Moleski met with staff member Aaron Fintel and explained the purpose of the visit.
LPA Moleski discussed the plans of correction with Fintel. LPA Moleski reviewed R4's appraisal/needs and services plan and observed it to be complete. Fintel provided LPA Moleski with a completed appraisal/needs and services plan for R1.
Fintel produced an LIC 308 designating him responsibility for the facility while the licensee is not available.
No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Fintel.
SUPERVISOR'S NAME:
Stephen Richardson
TELEPHONE:
(916) 263-4746
LICENSING EVALUATOR NAME:
Vincent Moleski
TELEPHONE:
(559) 365-5294
LICENSING EVALUATOR SIGNATURE:
DATE:
04/25/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/25/2024
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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