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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397004913
Report Date: 01/23/2025
Date Signed: 01/25/2025 08:43:34 PM

Document Has Been Signed on 01/25/2025 08:43 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:ZOSING CARE HOME IIFACILITY NUMBER:
397004913
ADMINISTRATOR/
DIRECTOR:		VELASQUEZ, ANGELICA & GENEFACILITY TYPE:
740
ADDRESS:2815 MIRASOL LANETELEPHONE:
(209) 955-1033
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
01/23/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Angelica VelasquezTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Unannounced Plan of Correction visit made out to this facility on 01/23/2025 by Licensing Program Analyst (LPA) Charlie Yang. This LPA was met by the facility designated Administrator Angelica Velasquez. A brief interview was conducted with the facility designated Administrator at this time.
Current census was 4 residents..
The purpose of this visit was to follow up on the deficiencies that were cited from a prior annual visit conducted on 12/09/2024. This visit was to follow up on the Plan of Correction that was due.

The following deficiencies were observed and cited on 12/09/2024:
  • Prior to accepting a resident for care and in order to evaluate his/her suitability, the facility shall, as specified in this article 8: (3) Obtain and evaluate a recent medical assessment.


Plan of Correction clearance letter was printed and a copy was provided to the facility designated Administrator at this time.

There were no further deficiencies observed or cited during today's Plan of Correction visit.

Exit Interview
Liza KingTELEPHONE: (650) 676-0442
Charlie YangTELEPHONE: (916) 709-6507
DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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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