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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700704
Report Date: 06/25/2024
Date Signed: 06/25/2024 04:41:57 PM

Document Has Been Signed on 06/25/2024 04:41 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:A HEARTY CARE HOME IFACILITY NUMBER:
342700704
ADMINISTRATOR/
DIRECTOR:		CLARDY, MARIA JFACILITY TYPE:
740
ADDRESS:5794 SPENLOW WAYTELEPHONE:
(916) 339-6440
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY: 6CENSUS: 4DATE:
06/25/2024
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Maria Clardy, AdministratorTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On June 25, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons had an announced case management Collateral visit with Maria Clardy, Administrator. Maria wanted to get LPA's advice on a situation with a resident. Administrator informed me that the resident has been demanding, controlling,using inappropriate language during showers and intimidating with staff. The administrator also informed me that he is behind on his rent. The resident moved in the facility Mid-Aril and is not up to date on his May and June 2024 rent. Administrator and LPA had a conversation on his behavior. We discussed how his behavior is not enough to evict the resident and discussed why. We will have additional conversations regarding the resident.

Per California Code of Regulations, Title 22, no citations were issued.

An exit interview was conducted and a copy of this report was given to Maria.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons
LICENSING EVALUATOR SIGNATURE: DATE: 06/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2024
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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