<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496830783
Report Date: 12/09/2022
Date Signed: 12/09/2022 10:01:14 AM

Document Has Been Signed on 12/09/2022 10:01 AM - 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:ANAMOR HOMEFACILITY NUMBER:
496830783
ADMINISTRATOR:TATAD, MARIA TERESAFACILITY TYPE:
737
ADDRESS:1204 SHADY OAK PLACETELEPHONE:
(707) 806-2831
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY: 4CENSUS: 4DATE:
12/09/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Administrator, Maria Teresa TatadTIME COMPLETED:
10:10 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst Bertozzi arrived unannounced to conduct a Case Management inspection and was greeted by staff. Administrator, Maria Teresa Tatad arrived later,

CCL recently received a report outlining some unmet needs for one of four clients. LPA is confirming that steps have been made to address those unmet needs. Per conversation with Administrator and review of updated plans, it appears facility has remedied or is working on remedying the noted issues.

No deficiencies cited during this inspection.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Victoria Bertozzi
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1