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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700352
Report Date: 04/26/2023
Date Signed: 04/26/2023 12:19:11 PM

Document Has Been Signed on 04/26/2023 12:19 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:BRICKS COMMUNITY CARE HOMEFACILITY NUMBER:
392700352
ADMINISTRATOR:LIMBRICK, ANTHONYFACILITY TYPE:
735
ADDRESS:3917 MARCHESOTTI WAYTELEPHONE:
(209) 362-5600
CITY:STOCKTONSTATE: CAZIP CODE:
95205
CAPACITY: 4CENSUS: 4DATE:
04/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:58 AM
MET WITH:Staff not presentTIME COMPLETED:
12:20 PM
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On 4-26-23 at 11:58am, Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to deliver a decision and order regarding an exclusion for staff1 (S1). LPA rang doorbell with no response, and called licensee with no response within 15 minutes. As a result, LPA was unable to deliver decision and order during today's case management visit.

LPA left message for Administrator Anthony Limbrick to make licensee aware of LPA's attempted visit. A copy of this report was mailed to Administrator with a request for return with signature.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2023
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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