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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701028
Report Date: 11/22/2021
Date Signed: 11/22/2021 02:29:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:MKS QUALITY CARE LLCFACILITY NUMBER:
342701028
ADMINISTRATOR:LEE, KEVINFACILITY TYPE:
740
ADDRESS:317 NATOMA ST.TELEPHONE:
(916) 831-7972
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:15CENSUS: 7DATE:
11/22/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Iana VoitehovschiTIME COMPLETED:
03:00 PM
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On 11/22/2021 LPA Tryon arrived at the facility to open a complaint. LPA met with Administrator Iana Voitehovschi.

While at the facility, LPA learned that there are numerous staff working at the facility whose fingerprints are not currently associated to the facility in the CCL systems (Guardian and LIS). When LPA met with Administrator Voitehovschi, LPA learned that she had sent transfer requests on ALL the staff. She provided copies of documents that were submitted and/or letters of clearance that are associated to the facility. It is unclear why none of the staff are showing up on the system as associated, but the facility has clearly made multiple attempts to have staff associated. Therefore, LPA will assist the facility to look into the issue.


At this time, no deficiencies are issued as the facility has clearly made attempts to comply with regulations.

Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021
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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