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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803017
Report Date: 10/28/2021
Date Signed: 10/28/2021 09:58:23 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:OPTIMUM SENIOR RESIDENTIAL CAREFACILITY NUMBER:
496803017
ADMINISTRATOR:ATUP, CORRIENEFACILITY TYPE:
740
ADDRESS:2540 SUMMERFIELD ROADTELEPHONE:
(707) 537-7420
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:6CENSUS: 0DATE:
10/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Staff, Eduardo BarbudoTIME COMPLETED:
10:10 AM
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Licensing Program Analyst (LPA) Erik Gonzalez-Campos arrived unannounced at Optimum Residential Care for a voluntary facility Closure, and met with staff, Eduardo Barbudo. Administrator was not present at the time of the visit. LPA spoke with administrator Corriene Atup over the phone who requested LPA perform closure inspection with staff. Administrator stated over the phone that new owners of the property intend to move in the next day October 29, 2021. At arrival LPA observed two staff in the process of cleaning facility and preparing items to be moved.

The Licensee notified Community Care Licensing of intent to close this facility on August 31, 2021 via email. Closure plans and copies of letters given to clients were reviewed. Licensee notified CCL that the facility was to be closed October 31, 2021.

The licensee initiated this facility closure. LPA inspected all rooms and the exterior of the building and found no evidence that would suggest that clients are residing on the premises. All clothing and personal items belonging to clients have been removed. Clients that were living in the home were relocated to other properties in Sonoma County.

Administrator will mail out license to the Regional Office. Facility will be closed effective October 29, 2021. A copy of this report was printed for Administrator, Corriene Atup.
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Erik Gonzalez CamposTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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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