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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496804136
Report Date: 09/26/2024
Date Signed: 09/26/2024 01:48:41 PM

Document Has Been Signed on 09/26/2024 01:48 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:HUNTER HOMEFACILITY NUMBER:
496804136
ADMINISTRATOR/
DIRECTOR:		ALLI, FUNMILOLA I.FACILITY TYPE:
734
ADDRESS:604 HUNTER LANETELEPHONE:
(909) 908-2766
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY: 4CENSUS: 4DATE:
09/26/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Funmilola (Lola) Alli-Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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An Informal meeting was conducted today, 9/26/24, in the Santa Rosa Regional Office. Present in the meeting were Licensing Program Manager (LPM) Bethany Moellers, Licensing Program Analyst (LPA) Dina Alviso, Licensee/Administrator Funmilola (Lola) Alli and Stanley Alli.The purpose of the Informal meeting was to address concerns regarding the operation of this license, ensuring compliance with regulations
at all times.

Items addressed were identified in a recent complaint investigation, complaint 21-AS-20240321142523, dated 9/26/24, see the following:

· Personal Rights- 80072

· Care For Clients with Incontinence- 80077.4

· Personnel Requirements- 80065

· Administrator Qualifications and Duties- 85064

Licensee/Administrator, Lola Alli and Stanley Alli, stated their understanding of the above discussed concerns, discussed regulations, and to ensure required compliance with the regulations. LPA provided copies of the discussed regulations listed above.

No citations issued during today’s informal meeting.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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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