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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002953
Report Date: 12/19/2023
Date Signed: 12/19/2023 04:49:42 PM


Document Has Been Signed on 12/19/2023 04:49 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:TUSCAN PALMS HOME CARE LLCFACILITY NUMBER:
345002953
ADMINISTRATOR:TIMIS, ALEXANDRU VICTORFACILITY TYPE:
740
ADDRESS:7921 ALMA MESA WAYTELEPHONE:
(279) 529-2363
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 5DATE:
12/19/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
04:35 PM
MET WITH:Alex Timis, Administrator TIME COMPLETED:
04:50 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual. LPA met with Alex Timis, Administrator, and explained purpose of the inspection. Also present was Angela Reckford-Campbell.

This report was generated to document/clear a post-licensing in the system.

The annual inspection was conducted today and is documented on a separate report.

There are no deficiencies 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: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2023
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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