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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 440707795
Report Date: 10/24/2024
Date Signed: 10/24/2024 01:45:25 PM

Document Has Been Signed on 10/24/2024 01:45 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
CENTRAL COAST CR/RES, 2580 N. FIRST STREET, STE. 350
SAN JOSE, CA 95131
FACILITY NAME:ROLLING RIDGE R.C.H.FACILITY NUMBER:
440707795
ADMINISTRATOR/
DIRECTOR:		CARLONE, MICHAELFACILITY TYPE:
735
ADDRESS:751 LARKIN VALLEY ROADTELEPHONE:
(831) 475-0888
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 12CENSUS: DATE:
10/24/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Michael CarloneTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 10/24/2024 San Bruno Regional Office - San Jose Unit conducted a non-compliance conference office meeting with Licensee/Administrator Michael Carlone and staff Casey Clark.

Regional Manager Vivien Helbling, Licensing Program Manager Jackie Jin, and Licensing Program Analyst David Marrufo were present in the meeting.

During the non-compliance meeting, the following serious violations were discussed: 80072(a)(3) - Personal Rights and 1558(a)(2) Persons prohibited from employment; dismissal or removal; appeal.

During this meeting, the compliance plan was developed and discussed with the licensee which includes more frequent monitoring inspection visits to ensure compliance with this compliance plan and Title 22 Regulations for 2 years. Licensee was provided with the link below for resources and guidance to improve facility operations:

https://www.cdss.ca.gov/inforesources/community-care/resource-guide-for-providers.

This report was reviewed with Licensee/Administrator Michael Carlone and staff Casey Clark and a copy of the report was provided.
SUPERVISORS NAME: Sarah Yip
LICENSING EVALUATOR NAME: David Marrufo
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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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