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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700758
Report Date: 03/06/2025
Date Signed: 03/06/2025 03:44:07 PM

Document Has Been Signed on 03/06/2025 03:44 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:LOVE AND COMFORT IIFACILITY NUMBER:
342700758
ADMINISTRATOR/
DIRECTOR:		VUNIMATANA, RATUFACILITY TYPE:
740
ADDRESS:320 BOWMAN AVETELEPHONE:
(916) 832-3626
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 6DATE:
03/06/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Eliesa Qiolele TIME VISIT/
INSPECTION COMPLETED:
04:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Holly Williams arrived unannounced to conduct a case management visit LPA Williams with facility administrator on the telephone Ratu Vunimatana and explained the purpose of the visit. LPA Williams asked Ratu Vunimatana to come to the facility but they refused stating they were at an appointment and said that Eliesa Qiolele can sign for Vunimatana.

Vunimatana sent LPA Williams eviction letters of 4 of the clients that were sent on February 27, 2025. LPA Williams reviewed these letters of eviction and observed that they are inaccurate. Halfway down on the second page of the eviction letter it states that the effective date of the eviction is September 18, 2024 and the eviction notice is signed on 2/27/25 which is past the 24 hour time limit of the Stipulation, Waver and Order. Within 24 hours of the date February 6, 2025 when the respondent received the order of this Stipulation, respondent shall give a 60 day written notice to each clients responsible party. LPA Williams interviewed all residents in care and all but 1 received the eviction letter and signed however, the residents responsible parties were suppose receive the eviction letter.

During todays visit LPA Williams interviewed residents in care regarding concerns of the change of ownership applicant taking over the facility without department approval. None of the residents interviewed corroborated that this has occurred.

This facility is being cited per H&S Section 1569.50 (a)(1)(3). An exit interview was held with Qiolele. Appeal rights and a copy of this report were left with Qiolele.
Czarrina A Camilon-LeeTELEPHONE: (916) 263-4700
Holly WilliamsTELEPHONE: 916-798-3161
DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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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Document Has Been Signed on 03/06/2025 03:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: LOVE AND COMFORT II
FACILITY NUMBER: 342700758

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/07/2025
Section Cited
HSC
1569.50(a)(1)(3)

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ยง1569.50(a)(1)(3)Violation by the licensee of this chapter or of the rules and regulations adopted under this chapter.
This requirement was not met as evidenced by...

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Licensee agrees to submit to LPA Williams in 24 hours a new and correct eviction notice and within 48 hours have them signed by the resident responsible parties. Licensee agrees to adhere to the Stipulation, Waiver and Order.Holly.williams@dss.ca.gov
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Based on record review, and interview the licensee did not comply with the Stipulation, Waiver and Order which poses an immediate health, safety and/or personnel rights risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Czarrina A Camilon-LeeTELEPHONE: (916) 263-4700
Holly WilliamsTELEPHONE: 916-798-3161

DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025

LIC809 (FAS) - (06/04)
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