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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005109
Report Date: 07/29/2021
Date Signed: 07/29/2021 02:57:08 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:AMERICAN RIVER CARE HOME 2FACILITY NUMBER:
347005109
ADMINISTRATOR:HARUE SEKIFACILITY TYPE:
740
ADDRESS:2801 TIOGA WAYTELEPHONE:
(916) 283-6716
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:6CENSUS: 6DATE:
07/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Hidenori Seki & Harue SekiTIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Avelina Martinez made an unannounced visit to this facility to conduct a case management on 07/29/2021 at 1:05 PM. LPA met with Harue Seki and Hidenori Seki and stated the purpose of today’s visit.

The purpose of this case management was to discuss increase in capacity. LPA Martinez was informed the licensee would like more information on increase of capacity and fire clearance information. LPA Martinez went over increase of capacity requirements with Harue Seki. LPA Martinez and Harue Seki also discussed having a tenant move into the facility, which any persons residing in the facility that is not considered to be a resident must be fingerprinted; obtain a background clearance; and be associated to the facility.

At this time, the licensee is following up on commercial fire alarm and fire sprinkler and possible fire rated construction. Moreover at this time, no resident or tenant will be moving into the facility.

There were no deficiencies cited and a exit interview was conducted with Hidenori Seki.

SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Avelina MartinezTELEPHONE: (916) 431-8935
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
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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