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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397002682
Report Date: 03/28/2024
Date Signed: 03/29/2024 09:37:24 AM


Document Has Been Signed on 03/29/2024 09:37 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:SUNNY PLACE OF STOCKTONFACILITY NUMBER:
397002682
ADMINISTRATOR:EXPECTACIO VIERRAFACILITY TYPE:
740
ADDRESS:807 WEST SWAIN ROADTELEPHONE:
(209) 956-8677
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:18CENSUS: 12DATE:
03/28/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:36 PM
MET WITH:E. VierraTIME COMPLETED:
02:45 PM
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On 3/28/2024, A case management visit was conducted by Albert Johnson, Licensing Program Analyst (LPA). LPA met with the Administrator and explain the reason for the visit.

The purpose of the case management visit was to follow up on the 30-day eviction notice given to R1and sent to the department. Based on the 30-day eviction notice sent to Licensing, Not all the requirements were met and the letter needs to be amended to include the required information.

LPA provide the facility with a sample notice and requested the facility resubmit the letter for approval before presenting it to R1.

Administrator informed LPA that she will revise the letter and send it to all necessary agency.

No deficiencies were cited. Sample letter emailed and a copy of this report.
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Albert JohnsonTELEPHONE: (916) 217-1390
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024
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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