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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700640
Report Date: 04/02/2024
Date Signed: 04/03/2024 09:30:46 AM


Document Has Been Signed on 04/03/2024 09:30 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:COURTYARD AT RIO LAS PALMAS, THEFACILITY NUMBER:
392700640
ADMINISTRATOR:GUERRERO, LIZETHFACILITY TYPE:
740
ADDRESS:877 EAST MARCH LANETELEPHONE:
(209) 957-4711
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:80CENSUS: 61DATE:
04/02/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:13 PM
MET WITH:Lizeth GuerreroTIME COMPLETED:
02:44 PM
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On 4/2/2024, LPA Johnson arrived and met with the Administrator, who assisted LPA with the visit to determine if the plan of correction has been completed for the citation given on 1/31/2024.

LPA reviewed the requirements of the Fire Marshal from the visit dated 1/2/2024. The required information has not been met and the facility does not have a generator that meets the fire clearance requirement. This was confirmed by the facilities' records and the fire prevention inspector's report. The facility is working with an outside agency to obtain a temporary generator that will be in place within 5 business days. The temporary generator will be used until the required generator is installed and functional. The facility currently has a fire clearance permit that expires 10/2024.

The original plan of correction date has passed. The facility had a plan to address the original citation given on 1/31/2024, however, additional information from the Fire Marshal requires that the facility put in place a level 1 generator since power failure would result in loss of life or serious injury.

The facility will submit a plan to the department when the temporary generator will be in place by the close of business on 4/9/2024. This is an extension of the plan for the citation given on 1/31/2024.

Exit interview conducted
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert JohnsonTELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:
DATE: 04/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/02/2024
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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