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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700554
Report Date: 11/28/2023
Date Signed: 11/28/2023 11:18:57 AM


Document Has Been Signed on 11/28/2023 11:18 AM - 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:ANGIES CARE HOMEFACILITY NUMBER:
342700554
ADMINISTRATOR:CRUDO, ANGELINAFACILITY TYPE:
740
ADDRESS:8558 SHERATON DRTELEPHONE:
(916) 962-2460
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 5DATE:
11/28/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Angelina Crudo, AdministratorTIME COMPLETED:
11:30 AM
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An informal conference was conducted at 10:30am on November 28, 2023, with Sacramento North Regional Office via Microsoft Teams. The purpose of this informal conference meeting is to address the denied fire clearance of the facility following an inspection conducted by the Sacramento Metropolitan Fire District on November 12, 2023. The Administrator was told that this Informal conference is a part of the Administrative Action process and that further noncompliance may result in an elevation to a formal noncompliance conference, which could lead to a referral to the Department's legal division for possible revocation of license.

The following Licensing staff were present:
Licensing Program Analyst (LPA) Michael Hood and Licensing Program Manager (LPM) Anthony Perez

The following facility representatives were present:
Administrator Angelina Crudo

The following topics were covered during today's meeting:
  • Fire clearance at the facility and time frames for which facility will make corrections and receive an updated fire clearance


Administrator stated that corrections recommended by fire inspection have been made as of today's date. LPA will conduct a follow-up visit to the facility at a future date and will request another fire inspection to be completed once corrections have been confirmed.

An exit interview was conducted and a copy of this report will be provided to the facility via email. A copy must be signed and returned to the Department.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2023
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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