<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
500306146
Report Date:
11/29/2023
Date Signed:
11/29/2023 02:54:03 PM
Document Has Been Signed on
11/29/2023 02:54 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
SACRAMENTO SOUTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
LAS PALMAS ESTATES
FACILITY NUMBER:
500306146
ADMINISTRATOR:
MILLER, KREGG
FACILITY TYPE:
740
ADDRESS:
1617 COLORADO
TELEPHONE:
(209) 632-8841
CITY:
TURLOCK
STATE:
CA
ZIP CODE:
95382
CAPACITY:
89
CENSUS:
0
DATE:
11/29/2023
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
03:00 PM
MET WITH:
Administrator Kregg Miller
TIME COMPLETED:
03:15 PM
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 Analysts (LPA) Jason Lund arrived at the facility announced to do a case management visit. LPA was met by Licensee/Administrator Kregg Miller and explained the reason for the the visit.
On 11/29/2023 LPA Lund observed no residents in care at the facility and the facility will be officially closed as of 11/29/2023.
Exit interview done and report given
SUPERVISOR'S NAME:
Lisa Rios
TELEPHONE:
(916) 969-9685
LICENSING EVALUATOR NAME:
Jason Lund
TELEPHONE:
(916) 223-6752
LICENSING EVALUATOR SIGNATURE:
DATE:
11/29/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/29/2023
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