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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500306146
Report Date: 01/14/2022
Date Signed: 02/01/2022 02:53:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:LAS PALMAS ESTATESFACILITY NUMBER:
500306146
ADMINISTRATOR:MILLER, KREGGFACILITY TYPE:
740
ADDRESS:1617 COLORADOTELEPHONE:
(209) 632-8841
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:89CENSUS: 86DATE:
01/14/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Kregg MillerTIME COMPLETED:
12:30 PM
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LPA Jason Lund arrived at the above facility to conduct a Proof of correction visit (POC). LPA Lund met with Administrator Kregg Miller and explained the reason for the visit. On 6/28/21 LPA Lund received an complaint for the facility not having liability insurance. The facility was cited for not having liability insurance until 8/1/2021 through 8/1/2022. The citation has been corrected.

Exit interview given and report left with Administrator Kregg Miller
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2022
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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