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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701060
Report Date: 01/11/2022
Date Signed: 01/11/2022 03:46:18 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:SV RESIDENTIAL FACILITY 2FACILITY NUMBER:
392701060
ADMINISTRATOR:YADAO, VIRGINIA ARRUBIOFACILITY TYPE:
740
ADDRESS:516 TULE SPRING STREETTELEPHONE:
(209) 915-9955
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:4CENSUS: DATE:
01/11/2022
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
03:23 PM
MET WITH:Virginia YadaoTIME COMPLETED:
03:45 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 1-11-22 at 3:23pm Licensing Program Analyst (LPA) Michael Bilger arrived unannounced to conduct a post-licensing inspection. LPA arrived at the door and rang doorbell. No answer received. LPA contacted Administrator Virginia Yadao who stated there are currently no clients in care at this time as facility is waiting for regional center approval to begin receiving clients. Administrator stated she is addressing a need at her other facility and is unable to come to this location at this time. As a result of today's visit, inspection was unable to be completed. LPA will contact Administrator at a later time to complete necessary visit. Administrator made aware of visit. Administrator unable to sign form due to absence.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Michael BilgerTELEPHONE: 916-862-4722
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2022
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