<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507002305
Report Date: 07/24/2023
Date Signed: 07/25/2023 08:15:04 AM

Document Has Been Signed on 07/25/2023 08:15 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
SACRAMENTO AC/SC, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:GARDE'S GUEST HOMEFACILITY NUMBER:
507002305
ADMINISTRATOR:IRENE GARDEFACILITY TYPE:
735
ADDRESS:3728 BRIDGEFORD LANETELEPHONE:
(209) 569-0625
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY: 6CENSUS: 4DATE:
07/24/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Irene GardeTIME COMPLETED:
02:00 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
Unannounced case management visit made out to this facility on 07/24/2023 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility designated Administrator, Irene Garde, who was briefly interviewed.
It was learned that the facility designated Administrator, Irene Garde, and her husband, Leo Garde, were live-in caregivers as well.
Current census was 4 residents.
The purpose of this visit was to follow up on a recent incident report that was submitted back on 07/09/2023 involving a resident, R1, and the details surrounding this event.
It was learned that the local police, Modesto PD, responded to this incident and gave a case number to the facility designated Administrator.
It was learned that there were still some outstanding conclusions that have yet to be determined so the outcome was not known at this time.
It was learned that no criminal charges have been brought forth against R1 or towards this facility at this time.

There were no deficiencies observed or cited during today's case management visit.

Exit Interview
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2023
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