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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390303860
Report Date: 10/30/2024
Date Signed: 10/30/2024 11:27:45 AM

Document Has Been Signed on 10/30/2024 11:27 AM - 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:OAKHAVENFACILITY NUMBER:
390303860
ADMINISTRATOR/
DIRECTOR:		MARIA LINDA ESTRADAFACILITY TYPE:
740
ADDRESS:725 EAST OAK STREETTELEPHONE:
(209) 465-2597
CITY:STOCKTONSTATE: CAZIP CODE:
95202
CAPACITY: 15TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/30/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:26 AM
MET WITH:Maria Linda EstradaTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Michael Bilger conducted an unannounced case management visit at facility on 10-30-24 at 10:26am for the proceeding of the facility closure. LPA met with Administrator Maria Linda Estrada and explained the purpose of this visit. A Notice of Facility Closure was originally received by the Regional Office on 1-4-24. Additional documentation received indicated all residents moved out of facility as of 10-5-24, and facility officially closed on 10-5-24.

LPA observed interior/exterior of the facility, including front and back yards, living room, activity 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 on approximately 11-6-24. A copy of this report was left with Administrator.

Link to survey for Facility Closure provided to Administrator.

www.surveymonkey.com/r/facilityclosure


Exit interview conducted.
Liza KingTELEPHONE: (650) 676-0442
Michael BilgerTELEPHONE: (916) 862-4722
DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
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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