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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507203056
Report Date: 12/19/2022
Date Signed: 12/20/2022 09:49:32 AM

Document Has Been Signed on 12/20/2022 09:49 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:STANDING OAK MANORFACILITY NUMBER:
507203056
ADMINISTRATOR:MARIA DENTONFACILITY TYPE:
735
ADDRESS:3770 STANDING OAK DRIVETELEPHONE:
(209) 541-1069
CITY:CERESSTATE: CAZIP CODE:
95307
CAPACITY: 6CENSUS: 5DATE:
12/19/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Rosita SantosTIME COMPLETED:
03:00 PM
NARRATIVE
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Unannounced case management visit made out to this facility on 12/19/2022 by Licensing Program Analyst (LPA) Charlie Yang who was met by the facility live-in caregiver, Rosita Santos, who was briefly interviewed. This LPA requested that the facility caregiver go ahead and contact the facility designated Administrator, Maria Denton, to inform her that CCL was present at this time.
It was learned that the facility designated Administrator was unable to make it to today's case management visit and allowed for the facility live-in caregiver, Rosita Santos, to go ahead and sign all of the documents related to CCL's visit at this time.
The purpose of this visit was to follow up on this facility's current status and future licensing status. It was learned from a prior visit on 11/17/2022 from the facility designated Administrator, Maria Denton, that this facility was possibly facing a closure and forfeiture of licensure. The main reason for this closure and forfeiture of license was mainly due to lack of staffing.
It was still unknown as to the actual closure date for this facility but the facility designated Administrator stated that the proper notice for residents, responsible parties, and CCL would all be taken into account once this decision was reached.
This LPA will continue to follow up with this facility and its designated Administrator in regards to this issue.

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

Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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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