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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502701481
Report Date: 02/12/2025
Date Signed: 02/12/2025 07:31:42 PM

Document Has Been Signed on 02/12/2025 07:31 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:HAPPY HOME LIVINGFACILITY NUMBER:
502701481
ADMINISTRATOR/
DIRECTOR:		ALLATRY, NADIAFACILITY TYPE:
740
ADDRESS:2525 CROMMELIN AVE.TELEPHONE:
(209) 232-0917
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY: 6CENSUS: 0DATE:
02/12/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:Nadia AllatryTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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Announced pre-licensing visit was made with applicants, Sammy & Nadia Allatry . LPA Jason Lund explained the reason for the visit.
The facility will be licensed to serve up to (6) clients at any given time. There were no residents in care during today's visit.
Tour/Inspection of the facility was conducted. LPA toured/Inspected 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 closet (locked) where medication will be stored. First aid kit was observed in the Medication closet to be present and contained all required components at this time.
A tour of the (6) private resident bedrooms, was conducted. Furnishings intended for use by the residents were observed to meet the needs of the residents at this time.
There are one linen closets, in the hallways, 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 in compliance and had a working telephone.
This facility has been found to be in compliance at this time.
Applicants completed the Component 111 requirements.
An exit interview was held and a copy of this report was left.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 02/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/12/2025
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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