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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920113
Report Date: 03/18/2025
Date Signed: 03/18/2025 02:24:59 PM

Document Has Been Signed on 03/18/2025 02:24 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:ASA CARE HOMES INCFACILITY NUMBER:
345920113
ADMINISTRATOR/
DIRECTOR:		SANTIAGO, ANNEDREAH JOYCEFACILITY TYPE:
735
ADDRESS:7720 GUENIVERE WAYTELEPHONE:
(916) 709-4612
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 4CENSUS: 3DATE:
03/18/2025
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Annedreah Santiago, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection and met with Hazel Natividad, caregiver. Administrator Annedreah Santiago was contacted and arrived around 11:30 am. There was (1) client present at the start of the inspection and in their room. (2) clients were attending day program and (1) client has been an outside rehabilitation facility since 1/17/25. The fire clearance is approved for (3) ambulatory clients and (1) non-ambulatory clients. All clients are ambulatory. (2) clients returned from day program around 2:00 pm and (1) ate a meal in the common area.

The home is vendorized through Alta California Regional Center and is a Level 6 (previously level 4I) home.

This report is being created to clear the Post-Licensing Inspection in the system.

There are no citations issued in this report.

Exit interview. Copy of report provided to the Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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