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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803065
Report Date: 02/07/2023
Date Signed: 02/07/2023 02:18:06 PM

Document Has Been Signed on 02/07/2023 02:18 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:MAEGAN'S CARE HOMEFACILITY NUMBER:
496803065
ADMINISTRATOR:CORALDE, LILIAFACILITY TYPE:
740
ADDRESS:2812 BETH COURTTELEPHONE:
(707) 527-9906
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY: 6CENSUS: 0DATE:
02/07/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Lilia Coralde-LicenseeTIME COMPLETED:
02:16 PM
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Licensing Program Analyst (LPA) Alviso conducted a case management and met with Licensee, Lilia Coralde.

The case management is being conducted to verify no clients are in care; The Licensee notified the Licensing office that they are closing the facility, and no longer interested in operating a care home.

Licensee Lilia Coralde returned the license the Department had provided to them to operate; LPA will return the document to the Licensing office.

LPA toured the home and verified there are no clients in care. This license is closed, and no longer valid, effective today, 2/7/2023.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2023
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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