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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700491
Report Date: 12/21/2020
Date Signed: 12/23/2020 11:27:15 AM

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:LOVE AND SERENITY IIFACILITY NUMBER:
342700491
ADMINISTRATOR:RATU P VUNIMATANAFACILITY TYPE:
740
ADDRESS:5942 PARK VILLAGE STTELEPHONE:
(916) 476-5595
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:6CENSUS: DATE:
12/21/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Javier Castro, Jr. TIME COMPLETED:
05:00 PM
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A Non-Compliance Conference was conducted today via teleconference with Sacramento North and South Regional Offices. The purpose of this Non-Compliance Conference meeting is to discuss the high volume of complaints/inability to remain in substantial compliance with the regulations/or specific incident that has occurred in the last 24 months. Present in the meeting is Regional Manager Krystall Moore, Central Application Bureau (CAB) Staff Services Manager II Hao Nguyen, CAB Staff Services Manager I Tracy Thompson, Licensing Program Manager (LPM) Czarrina Camilon-Lee, LPM Liza King, LPM Stephen Richardson, Acting Regional Manager Laura Munoz, LPM Stephenie Doub, Licensing Program Analyst (LPA) Victoria Brown, LPA Tung Truong, LPA Jasmine McCrory, and Licensees and Administrator(s) Mike Her and Bianca Castro, LOVE AND SERENITY LLC, representative Javier Castro Jr. The Non-Compliance Conference process was explained during this meeting.

A Non-Compliance Conference Summary (LIC 9111) was generated to document this office meeting.

A copy of this report and the LIC 9111 was provided to the Licensee.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Jasmine McCroryTELEPHONE: (916) 214-5020
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2020
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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