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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920012
Report Date: 04/29/2024
Date Signed: 04/29/2024 05:00:59 PM


Document Has Been Signed on 04/29/2024 05:00 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:SAINT THOMAS CARE HOMEFACILITY NUMBER:
345920012
ADMINISTRATOR:MAGUREAN, EVELINAFACILITY TYPE:
740
ADDRESS:4905 SAINT THOMAS DRIVETELEPHONE:
(916) 880-0551
CITY:FAIR OAKSSTATE: CAZIP CODE:
95628
CAPACITY:6CENSUS: 4DATE:
04/29/2024
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Evelina Magurean, AdministratorTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Michael Hood arrived at the care home today and met with the Administrator, Evelina Magurean, to conduct an annual required and post licensing visit.

For more information on the post licensing visit, please see LIC 809 for Required - 1 Year dated 4/29/24.

No deficiencies cited for the post licensing visit.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 04/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/29/2024
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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