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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700754
Report Date: 07/11/2023
Date Signed: 07/12/2023 08:35:09 AM

Document Has Been Signed on 07/12/2023 08:35 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:DREAM CAREFACILITY NUMBER:
502700754
ADMINISTRATOR:HAWES, JULIANFACILITY TYPE:
735
ADDRESS:2004 KRUGER DRIVETELEPHONE:
(209) 661-4666
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 4CENSUS: 4DATE:
07/11/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Julian HawesTIME COMPLETED:
05:00 PM
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A Non-Compliance Conference (NCC) was conducted on this day, 07/11/2023, by the Sacramento South Regional Office via Zoom. The purpose of this NCC meeting was to discuss the high volume of deficiencies/inability of this facility to remain in substantial compliance with the regulations that have occurred within the last 12 months. Present at the meeting were Regional Manager (RM), Stephenie Doub, Licensing Program Manager (LPM), Stephen Richardson, Licensing Program Analyst (LPA), Arielle Pascua, Licensing Auditor, Diana Chapman, Valley Mountain Regional Center (VMRC) Community Services Director, Brian Bennett, VMRC Quality Assurance Division Manager, VMRC Liaison, Wanda Johnson, Licensee, Julian Hawes, and Jacob Reinhardt. The Non-Compliance Conference process was explained during this meeting to include the administrative process.

Items discussed during the Non-Compliance Conference were:

  • Personal and Incidental Money
  • Personal Rights of the Residents
  • Reporting Requirements
  • Inspection Authority
  • Plan of Corrections

Licensee agreed to do the following in order to bring the facility into compliance no later than the following date 07/21/2023.
  • All documentation that have been requested by the Audits department.
  • Training for all staff regarding personal rights.
  • Training for all staff regarding reporting requirements.
  • Training for all staff regarding inspection authority

SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: DREAM CARE
FACILITY NUMBER: 502700754
VISIT DATE: 07/11/2023
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In addition, at this meeting the notified Licensee/Administrator was advised future non-compliance regarding the above and other regulatory components will result in additional citations, civil penalties, and further potential administrative action.


Community Care Licensing Department (CCLD) will do the following:
  • Increase Monitoring to quarterly visits.

Completing the Non-Compliance Conference does not deprive the Department of its authority to take appropriate formal legal action under the Health and Safety Code if such action is deemed necessary by the Regional Manager.

Per California Code of Regulations (CCRs) - Title 22 no deficiencies are being cited during this visit. An exit interview was conducted with Licensee, Julian Hawes, and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents. In addition, a copy of this report will be sent out certified mail.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Arielle Pascua
LICENSING EVALUATOR SIGNATURE:

DATE: 07/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023
LIC809 (FAS) - (06/04)
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