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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347000498
Report Date: 06/28/2021
Date Signed: 06/28/2021 05:04:36 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:CARING FAMILIES, EGFFACILITY NUMBER:
347000498
ADMINISTRATOR:FITZPATRICK, TAMARAFACILITY TYPE:
740
ADDRESS:9308 ELK GROVE-FLORIN RDTELEPHONE:
(916) 685-1134
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY:10CENSUS: 0DATE:
06/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:44 PM
MET WITH:Kara FitzpatrickTIME COMPLETED:
05:15 PM
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Licensing Program Analyst (LPA) Michael Bilger conducted an unannounced case management visit at facility on 6/28/21 at 4:44pm for the proceeding of the facility closure. Upon LPA's arrival, Administrator Lorrena Goodenough was not at facility. LPA spoke with Administrator via phone and explained the purpose of today's visit., who gave permission for staff member Kara Fitzpatrick to sign and receive paperwork. A Notice of Facility Closure was received by the Regional Office on 6-1-21 with a facility closure date of 7/20/21. 60-day notices to all residents were given on 5-20-21. Administrator submitted closure roster to LPA on 6/24/21.

LPA observed interior/exterior of the facility, including front and back yards, living room, dining room, kitchen, bathrooms, and all bedrooms. LPAs observed that there were no residents at the facility.

LPA retrieved original license and informed Administrator that the facility will be closed in the system as of 6/28/21. A copy of this report was left with Administrator.

Link to survey for Facility Closure provided to Kara.

www.surveymonkey.com/r/facilityclosure


Exit interview conducted.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2021
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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