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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496830756
Report Date: 01/29/2025
Date Signed: 01/29/2025 02:22:00 PM

Document Has Been Signed on 01/29/2025 02:22 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:MUIRWOODS MEMORY CAREFACILITY NUMBER:
496830756
ADMINISTRATOR/
DIRECTOR:		CAMILLE BROWNFACILITY TYPE:
740
ADDRESS:750 NORTH MCDOWELL BLVDTELEPHONE:
(707) 775-4330
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY: 80TOTAL ENROLLED CHILDREN: 0CENSUS: 47DATE:
01/29/2025
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Administrator Camille Brown, &Kimberly Kooy, Reg. DHW, via Teams - Courtney Lane, Regional Dir. of Opps., and, Denise Munoz, Corporate Dir. of Administration.TIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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An informal meeting was conducted today in the Santa Rosa Regional Office with some participants via Microsoft Teams. Present in the meeting were, Licensing Program Manager, Bethany Moellers, Licensing Program Analyst, Shannan Hansen, Administrator Camille Brown & Kimberly Kooy, Reg. DHW via Teams - Courtney Lane, Regional Dir. of Opps. and Denise Munoz, Corporate Dir. of Administration.

The purpose of the informal office meeting is to discuss civil case judgement that was determined in August 2024 and if there were any solvency concerns with the facility, as well, delivering complaint findings of 21-AS-20240719150606. Administrator informed there are no concerns regarding facilities financial solvency.

The following was discussed during the office meeting:

· Solvency Issues due to civil case judgement

· Findings of complaint 21-AS-20240719150606

Bethany MoellersTELEPHONE: (707) 588-5026
Shannan HansenTELEPHONE: 707-588-5026
DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2025
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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