<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701321
Report Date: 02/27/2024
Date Signed: 02/27/2024 10:56:38 AM


Document Has Been Signed on 02/27/2024 10:56 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:ST. MARTIN'S CARE HOMEFACILITY NUMBER:
342701321
ADMINISTRATOR:RODIL, MARTINFACILITY TYPE:
740
ADDRESS:10720 BECLAN DRIVETELEPHONE:
(916) 934-9327
CITY:RANCHO CORDOVASTATE: CAZIP CODE:
95670
CAPACITY:6CENSUS: 0DATE:
02/27/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Marty RodilTIME COMPLETED:
11:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/27/24, Licensing Program Analyst (LPA) Kimberly Viarella made an announced pre-licensing inspection visit to this facility to verify that the corrections required to be in compliance were addressed. LPA identified herself upon arrival, stated the purpose of the visit and met with Licensee and Designated Facility Administrator (DFA), Marty Rodil. LPA conducted a walkthrough of this facility and completed Comp III.

Facility has met Title 22 requirements at this time, no further action required. Please continue processing the application for a License.

A copy of this report was provided.

Exit interview.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly ViarellaTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1