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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347002709
Report Date: 12/10/2024
Date Signed: 12/10/2024 02:51:07 PM

Document Has Been Signed on 12/10/2024 02:51 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:A TLC HOMEFACILITY NUMBER:
347002709
ADMINISTRATOR/
DIRECTOR:		POP, AURICAFACILITY TYPE:
740
ADDRESS:7338 CROSS DRIVETELEPHONE:
(916) 725-2008
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Aurica Pop, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual.
LPA met with Aurica Pop, Administrator, and explained purpose of inspection.

Administrator stated the facility remains non-operational as a licensed facility; however, she would still like to keep the license open. Currently, the location remains operating as a room and board facility, with (1) tenant, and there is no license required.

Administrator hopes to possibly operate again in the next year with the assistance of a family member. Administrator stated annual fees are current.

LPA toured the interior of the facility and did not observe any RCFE residents. LPA observed the (1) tenant to be in their room.

Administrator was advised to notify the Department if she is planning to accept any RCFE residents or close the license. LPA observed a current copy of the Administrator's RCFE Certificate #6011403740- exp 5/3/25. Administrator stated she has completed (40) required hours to renew her certificate and will submit it soon.

LPA to provide information on the Administrator portal, as requested, and contact information to the Administrator Certification unit. LPA confirmed the email address on file is still current.

There are no deficiencies issued.

Exit interview. Copy of report provided to Administrator.
Maribeth SentyTELEPHONE: (916) 263-4813
Sabrina CalzadaTELEPHONE: (510) 829-2133
DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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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