<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700361
Report Date: 10/28/2020
Date Signed: 10/28/2020 03:20:54 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:STACIE'S CHALET STOCKTONFACILITY NUMBER:
392700361
ADMINISTRATOR:PARKER, JADEFACILITY TYPE:
740
ADDRESS:517 E FULTON STTELEPHONE:
(209) 466-2116
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:114CENSUS: 80DATE:
10/28/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Patricia Wong, LicenseeTIME COMPLETED:
02:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/28/2020 at 2:00pm, CCLD Sacramento South conducted a conference call with the Licensee.. Present in the meeting were Regional Manager Krystall Moore; Licensing Program Manager Czarrina Camilon-Lee; Licensing Program Manager Liza King; Licensing Program Analyst Treana White; Licensing Program Analyst Diego Escobar; Jim Hazzard from JCH Senior Housing Investment Brokerage, Representatives from MGSACT Hatixhe Grbeshi (COO), Patricia Wong (CEO), James Wong, Fred Fucanan Co-owner; and Anu Saini on behalf of the prospective licensee to discuss the potential sale of the facility.

LPMs discussed the Change of Ownership Procedures, Facility Closure Procedures and Eviction procedures.

Issues discussed at the meeting included, but not limited to:
  • Change of Ownership
  • Leaseback Agreement
  • Facility Purchase Agreement
  • Facility Closure Plan
  • Eviction Notices
  • Facility retention and limitations
  • Assisted Living Waiver Program (ALWP)

Licensee agreed to do the following:
  • CCLD will be provided copies of the eviction notices given to residents and their responsible party.
  • ALWP will be notified of the facility's intention to sell.
  • CCLD will be provided copies of the facility's closure plan.
  • CCLD will be provided with a leaseback agreement between the new owners and current licensee.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) -26-4752
LICENSING EVALUATOR NAME: Diego EscobarTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1