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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803260
Report Date: 08/15/2024
Date Signed: 08/15/2024 03:45:29 PM

Document Has Been Signed on 08/15/2024 03:45 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:RYAN HOUSEFACILITY NUMBER:
496803260
ADMINISTRATOR/
DIRECTOR:		GAUSE, LIYAN ZHANGFACILITY TYPE:
735
ADDRESS:4033 PRINCETON DRIVETELEPHONE:
(707) 578-5707
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY: 3CENSUS: 0DATE:
08/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:14 PM
MET WITH:Liyan Zhang Gause, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analysts (LPAs) Coppo and Cuadra arrived announced to conduct a Required - Year Inspection and met with Ralph Gause, Licensee.

At 2:35 PM, the facility was toured. There are currently no residents in care. Potential resident rooms are currently furnished with required furnishings. Water temperature measured 107.6 degrees F which is within regulation. All medication and client/personnel records are to be stored in the locked hall closet. Cleaners, toxins, and items that can pose a danger will be stored in a locked cabinet in the garage. LPA discussed some documents required upon admission of clients and hiring of personnel. Licensee does not plan to handle client's cash resources.

The fire extinguisher located in the laundry room was inspected and found to be charged. Facility continues to have fire inspections. All exits are accessible and free of debris. Administrator Certificates are current; Ralph Gause, 7035951735, expires on 2/4/2025 and Liyan Gause, 7035952735, expires on 3/16/25.

Exit interview conducted with Licensee.


No deficiencies were cited during todays visit.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Christi Coppo
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2024
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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