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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392701478
Report Date: 02/12/2025
Date Signed: 02/12/2025 12:48:16 PM

Document Has Been Signed on 02/12/2025 12:48 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:TARLOH ENTERPRISEFACILITY NUMBER:
392701478
ADMINISTRATOR/
DIRECTOR:		WALTERS, JOSEPHFACILITY TYPE:
735
ADDRESS:9430 TUSCANY CIRTELEPHONE:
(209) 323-4760
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 4CENSUS: 0DATE:
02/12/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Joseph WaltersTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Michael Bilger conducted an announced pre-licensing visit to this facility on 2/12/25 at 10:15am and was met by the Applicant Joseph Walters. Brief interview was conducted with the Applicant.
It was learned through review of the approved fire clearance that this facility will be licensed as an adult residential facility to serve up to 4 ambulatory clients. Rooms #1-4 are designated as ambulatory rooms.. A separate room is designated staff use. This Applicant is also seeking vendorization to accept and retain Level 6 clients. There were no clients present during today's pre-licensing visit. Tour of the facility was conducted. Dining area, living area, and all other areas intended for resident use were toured and observed to be furnished and maintained in compliance at this time. LPA observed no obstruction of emergency exits. Exit signs in place as appropriate. Fire extinguishers in place in hallways and kitchen, and fully charged. Facility map indicating emergency exits posted in appropriate locations. Resident rights poster in place. Kitchen area was toured. Cabinets and drawers were opened and reviewed by this LPA along with the Applicant. Food supply including emergency supply of food was observed.
Medication cabinet, located in the kitchen area, was toured. First aid kit was observed to be present and contained all required components at this time. A tour of the resident bedrooms was conducted. Furnishings and furniture intended for use by the clients were observed to be sufficient and able to meet the needs of the clients at this time. A tour of the resident bathrooms was conducted. Hot water temperatures were taken and measured within the range of 105-120 degrees. Linen closet, located in the hallway, was observed to contain a sufficient supply of towels and linens able to meet the needs of the residents at this time. A tour of the exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time.
This facility has been found to be in compliance at this time. There were no deficiencies observed during today's Pre-licensing visit. Component III completed with applicant. An exit interview was conducted with applicant and a copy of this report was provided.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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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