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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507002685
Report Date: 10/01/2021
Date Signed: 05/17/2022 02:59:09 PM


Document Has Been Signed on 05/17/2022 02:59 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:ST. FRANCIS ASSISTED CAREFACILITY NUMBER:
507002685
ADMINISTRATOR:JAMI YOUNGFACILITY TYPE:
740
ADDRESS:120 TWENTIETH CENTURY BLVDTELEPHONE:
(209) 668-8014
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:56CENSUS: 31DATE:
10/01/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Tej Dhillon, Licensee RepresentativeTIME COMPLETED:
02:00 PM
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An office meeting was held on this day In the Sacramento South Regional Office via Teams. Present in the meeting were Regional Manager (RM) Krystall Moore, Licensing Program Manager (LPM) Stephenie Doub, Licensee Representative Tej Dhillon and Sat Dhillon.

The purpose of the meeting was to discuss the facility's lack of an administrator. On 9/17/2021 the facility was cited California Code of Regulations Section 87405(a) Administrator Qualifications and Duties due to the facility not having a certified administrator with a POC date of 9/20/2021. On 9/20/2021 the facility notified CCL that they had hired an administrator, but upon review it was learned that this individual did not have a valid administrator's certificate. As of this day, the licensee has not designated a certified administrator to oversee the operations of the facility. The licensee stated that they continue to work with the applicant to secure their administrator's certificate and continue to be present in the facility to provide oversight.

During the meeting the licensee was advised that civil penalties continue to accrue for failure to correct the deficiency at $100 per day, which is currently at $1100.

An exit interview was conducted with the licensee representatives and a copy of this report was provided via email along with civil penalty assessment. A confirmation read receipt acknowledges receipt of this report.
SUPERVISOR'S NAME: Krystall MooreTELEPHONE: (916) 263-4707
LICENSING EVALUATOR NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR SIGNATURE:
DATE: 10/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/01/2021
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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