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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701354
Report Date: 10/31/2024
Date Signed: 10/31/2024 12:58:45 PM

Document Has Been Signed on 10/31/2024 12:58 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:HIDDEN TREASURES RESIDENTIAL IFACILITY NUMBER:
502701354
ADMINISTRATOR/
DIRECTOR:		ASHIEGBU, CHLOEFACILITY TYPE:
735
ADDRESS:924 TIPTON LANETELEPHONE:
(925) 523-1605
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY: 4CENSUS: 0DATE:
10/31/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Chloe AshiegbuTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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Announced pre-licensing visit was with applicant, Chloe Ashiegbu. LPA Jason Lund explained the reason for the visit.
The facility will be licensed to serve up to (4) clients at any given time. This Applicant was also seeking a program through Regional Center retain up to (4) clients at any given time. Census 0
LPA Lund toured the dining area, living area, and all other areas intended for client use. LPA observed to be furnished and maintained in compliance at this time.
The Facility had a Medication locked in the kitchen where medication will be stored. First aid kit was observed in the hall way closet to be present and contained all required components at this time.
A tour of the (4) private resident bedrooms, was conducted. Furnishings intended for use by the residents were observed to meet the needs of the residents at this time. The Facility also had an office for staff. The facility also had two restrooms for clients in care and one restroom for staff.
There is one linen closets, in the hallway, it was observed to contain a sufficient supply of towels and linens able to meet the needs of the clients at this time.
A tour of the exterior grounds was conducted. A review of the facility perimeter fence, side gates, and walkways were observed to be maintained in compliance at this time. The facility has one fire extinguisher that expires on 10/28/2025 and had a working telephone. This facility has been found to be in compliance at this time.
Applicant, Chloe Ashiegbu completed the Component 111 requirements.
Exit Interview and report left.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2024
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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