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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700828
Report Date: 02/11/2025
Date Signed: 02/11/2025 01:20:03 PM

Document Has Been Signed on 02/11/2025 01:20 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 SERENITY OF ELK GROVE IIIFACILITY NUMBER:
342700828
ADMINISTRATOR/
DIRECTOR:
CASTRO, BIANCAFACILITY TYPE:
740
ADDRESS:9442 MAZATLAN WAYTELEPHONE:
(916) 585-5483
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 6CENSUS: 4DATE:
02/11/2025
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Staff on dutyTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 1/23/2025, Licensing Program Analyst (LPA) Arvin Villanueva arrived unannounced at this facility to conduct a case management visit. LPA met with staff on duty, Omar Slypher, and stated the purpose of the visit. The administrator, Bianca Castro, was notified of the visit and gave permission to Omar to sign this report. Present during this visit were 3 residents in care with 1 staff on duty.

LPA conducted a physical inspection of the facility. Room temperature was measured at 75*F and hot water temperature was measured at 115*F in one of the bathrooms. 2 resident bedrooms were inspected and were observed to be clean and good repair. 2 resident bathrooms was inspected and were observed to be maintained and in good repair. Kitchen was observed to be clean and in good repair. Facility maintains adequate amount of food items. Medications, sharp objects and toxic chemicals were observed to be locked and inaccessible to residents in care. Fire extinguisher was observed to be maintained and was last serviced on 1/8/2025.

LPA noted that two residents were in their bedroom watching TV, while one was in the living room watching squirrels in the backyard. The other resident was out in the community for an appointment. The outdoor area appeared to be well-maintained at the time. The staff on duty was observed cleaning and preparing dinner.

Bianca remains the current administrator, and no new administrator has been hired. No new residents have been admitted since the last visit on 1/23/25. According to the staff on duty, no new staff have been associated to the facility since the previous visit on 1/23/25.


Exit interview was conducted with Omar and a copy of this report was provided.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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