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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002921
Report Date: 10/09/2023
Date Signed: 10/09/2023 02:16:11 PM


Document Has Been Signed on 10/09/2023 02:16 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:GRANNY'S COTTAGE LLCFACILITY NUMBER:
345002921
ADMINISTRATOR:BANCU, ADALBERTHFACILITY TYPE:
740
ADDRESS:7717 DEANTON CT.TELEPHONE:
(916) 606-9670
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 5DATE:
10/09/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Adalberth "Albert" Bancu, AdministratorTIME COMPLETED:
11:20 AM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with caregivers, and explained purpose of inspection. Albert Bancu, Administrator, arrived at approximately 11:30 am.

LPA is conducting an annual inspection today but this report is being generated to clear the Post-Licensing inspection in the system.

There are no citations issued on this report.

Exit interview. Copy of report provided to the Administrator.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2023
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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