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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701278
Report Date: 06/22/2023
Date Signed: 06/22/2023 10:25:25 AM


Document Has Been Signed on 06/22/2023 10:25 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 AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:CHEROKEE RETIREMENT HOMEFACILITY NUMBER:
392701278
ADMINISTRATOR:SINGH, JAKTARFACILITY TYPE:
740
ADDRESS:4124 CHEROKEE RDTELEPHONE:
(209) 518-1908
CITY:STOCKTONSTATE: CAZIP CODE:
95215
CAPACITY:15CENSUS: 13DATE:
06/22/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rick Reed and Jagtar SinghTIME COMPLETED:
10:30 AM
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 6/22/23 at approximately 9:00am Licensing Program Analysts (LPAs) Maja Jensen and Jennifer Fain arrived at facility unannounced to conduct a pre-licensing inspection/change of ownership. LPAs Jensen and Fain met with current licensee Rick Reed and prospective licensee Jagtar Singh and discussed the purpose of the visit.

LPAs Jensen and Fain were advised the financial transaction between the current licensee and prospective licensee is not complete and the current licensee is unwilling to relinquish his licensee until he has received payment in full. The current licensee and prospective licensee both mutually agree that they will need a minimum of an additional 7 days to complete the transaction.

As the licensee and applicant are not prepared to complete the pre-licensing inspection the visit will be postponed until after 6/29/23.

An exit interview was conducted and a copy of this report was provided to both the current licensee, Rick Reed and the applicant/prospective licensee, Jagtar Singh.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Jennifer FainTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2023
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