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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002893
Report Date: 06/29/2023
Date Signed: 06/29/2023 04:02:53 PM

Document Has Been Signed on 06/29/2023 04:02 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:BEST LIFE-EASTSIDEFACILITY NUMBER:
345002893
ADMINISTRATOR:CRAMPTON, JOSHUAFACILITY TYPE:
735
ADDRESS:3801 BILSTED WAYTELEPHONE:
(540) 383-3134
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY: 4CENSUS: 3DATE:
06/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Tania CramptonTIME COMPLETED:
04:12 PM
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LPA Hiratsuka conducted this unannounced annual visit. LPA toured the facility with Administrator Tania Crampton.

This is a two-story facility. The second floor has the resident rooms, full common bathroom, and a staff room that has a full bathroom. The first floor has a staff room, full bathroom, half bathroom, laundry room, common areas, and a door leading to the garage. The backyard was inspected. LPA did not observe any health and safety violations.

Two staff and two resident records were reviewed.

Several topics were discussed.

No deficiencies cited.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
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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