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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700814
Report Date: 05/06/2022
Date Signed: 05/06/2022 04:23:43 PM


Document Has Been Signed on 05/06/2022 04:23 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:A LOVING PLACE FOR YOUR PARENTSFACILITY NUMBER:
392700814
ADMINISTRATOR:DENISE ORDONEZFACILITY TYPE:
740
ADDRESS:488 POELSTRA COURTTELEPHONE:
(714) 948-0381
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY:6CENSUS: DATE:
05/06/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Nataley MartinezTIME COMPLETED:
03:50 PM
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On 5/6/22 at 3:30pm a Community Care Licensing Division (CCLD) virtual office meeting was conducted with the following attendees: Krystal Moore, Regional Manager, Liza King, Licensing Program Manager, Stephenie Doub, Licensing Program Manager, Maja Jensen, Licensing Program Analyst Maja and Nataley Martinez, Licensee. The purpose of the office meeting was to discuss matters related to the operation of the Nataley Martinez' licensed care facilities.

During the course of the meeting Regional Manager Krystal Moore advised Licensee Nataley Martinez that CCLD has received information from multiple sources that an excluded party, Ryta Martinez, is involved in the operation of her facilities. The Licensee advised CCLD that the allegation is untrue and is the result of a falling out with a long time family friend who is now making false accusations against her. The Regional Manager asked the Licensee why Ryta Martinez, who is an excluded party, was on the lease for her properties. The Licensee stated that Ryta Martinez had been leasing the property prior to her taking over. The Regional Manager reminded the Licensee that an excluded party cannot have any involvement in any DSS licensed facilities in any capacity and this includes but is not limited to visiting, billing, being on a lease, providing care or dealing with staff. The Licensee was also advised that continuing to allow an excluded party to have any presence or involvement in a licensed facility could result in CCLD pursuing a revocation of her license.

Licensing Program Manager Liza King asked Licensee Nataley Martinez if she had revised the eviction notices for the residents of A Loving Place For Your Parents. Nataley Martinez confirmed she had revised the eviction notices and issued them to residents. The Licensee also confirmed that she had secured a new lease for the relocation site that allows for 2 hospice residents and that she had overnighted the new lease to her Central Applications Bureau Analyst. The Licensee agreed to email the final draft eviction notices and a resident roster to Licensing Program Analyst Maja Jensen by close of business on Monday May 9, 2022.

A copy of this report was read to Licensee Nataley Martinez over the telephone and was emailed to the Licensee for a signature.

SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/06/2022
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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