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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397005130
Report Date: 03/07/2025
Date Signed: 03/11/2025 10:43:25 AM

Document Has Been Signed on 03/11/2025 10:43 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:TELECARE SAN JOAQUIN CRISIS RESIDENTIAL SERVICESFACILITY NUMBER:
397005130
ADMINISTRATOR/
DIRECTOR:		RAKSMEY ROEUM-CASTLEMANFACILITY TYPE:
772
ADDRESS:5634 JEREMY WAYTELEPHONE:
(209) 888-4969
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY: 6CENSUS: 5DATE:
03/07/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Raksmey CastlemanTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Unannounced Plan of Correction visit made out to this facility on 03/07/2025 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Raksmey Castleman, who was briefly interviewed at this time.
Current census was 5 residents.
The purpose of this visit was to follow up on the deficiencies that were cited from a prior annual visit conducted on 02/06/2025. This visit was to follow up on the Plans of Correction that were due.
The following deficiencies were observed and cited on 02/06/2025:
  • The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

  • All window screens shall be in good repair and be free of insects, dirt and other debris.


This facility did complete the Plans of Correction and provided all of the required forms and documents at this time.
Plan of Correction clearance letters were printed and copies were 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
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2025
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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