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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 435200950
Report Date: 04/06/2022
Date Signed: 04/06/2022 10:35:52 AM


Document Has Been Signed on 04/06/2022 10:35 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
CCLD Regional Office,
, CA



FACILITY NAME:SORIANO RESIDENTIAL CARE HOMEFACILITY NUMBER:
435200950
ADMINISTRATOR:SORIANO, MARIAFACILITY TYPE:
740
ADDRESS:227 WEST CAPITOL AVENUETELEPHONE:
(408) 684-4070
CITY:MILPITASSTATE: CAZIP CODE:
95035
CAPACITY:6CENSUS: 0DATE:
04/06/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Maria Soriano TIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Marybeth Donovan arrived unannounced to conduct a facility closure visit. LPA met with Maria Soriano Administrator/Licensee and inspected the facility inside and out. There were no residents in care and the facility operations have ceased.

Maria Soriano Administrator/Licensee surrendered the facility License. The effective closure date of the facility is February 28, 2022.

LPA reviewed this report with Maria Soriano Administrator/Licensee and provided a copy of the report provided.
SUPERVISOR'S NAME: Jackie JinTELEPHONE: (714) 319-3786
LICENSING EVALUATOR NAME: Marybeth DonovanTELEPHONE: (408) 726-4301
LICENSING EVALUATOR SIGNATURE:
DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/06/2022
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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