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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
486804139
Report Date:
06/06/2023
Date Signed:
06/06/2023 01:11:11 PM
Document Has Been Signed on
06/06/2023 01:11 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
CCLD Regional Office
,
1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA
,
CA
95405
FACILITY NAME:
SOLANO HOUSE
FACILITY NUMBER:
486804139
ADMINISTRATOR:
HALL, ELIZABETH
FACILITY TYPE:
735
ADDRESS:
2251,2261,& 2271 S WATNEY WAY
TELEPHONE:
(530) 758-2160
CITY:
FAIRFIELD
STATE:
CA
ZIP CODE:
94533
CAPACITY:
32
CENSUS:
8
DATE:
06/06/2023
TYPE OF VISIT:
POC
UNANNOUNCED
TIME BEGAN:
12:45 AM
MET WITH:
Jessica Stillman
TIME COMPLETED:
01:15 PM
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Licensing Program Analyst Leibert arrived unannounced for the purpose of conducting a POC visit. LPA conducted an inspection of the repaired plumbing lines which included construction repairs to two bedrooms and bathrooms. Front door to the Office building previously found to be operating satisfactorily after a repair. All buildings and grounds deficiencies previously identified have been cleared.
Report left.
No citations issued today.
SUPERVISORS NAME
:
Carla Martinez
LICENSING EVALUATOR NAME
:
David Leibert
LICENSING EVALUATOR SIGNATURE
:
DATE:
06/06/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
06/06/2023
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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