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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
517004518
Report Date:
01/16/2025
Date Signed:
01/16/2025 11:28:44 AM
Document Has Been Signed on
01/16/2025 11:28 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 NORTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
PRIDE INDUSTRIES, YUBA CITY
FACILITY NUMBER:
517004518
ADMINISTRATOR/
DIRECTOR:
NAVARRETE, MERIDA
FACILITY TYPE:
775
ADDRESS:
950 THARP ROAD, #601
TELEPHONE:
(530) 755-1736
CITY:
YUBA CITY
STATE:
CA
ZIP CODE:
95993
CAPACITY:
45
CENSUS:
DATE:
01/16/2025
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:
Merida Naverrete and Marina Nagel
TIME VISIT/
INSPECTION COMPLETED:
11:35 AM
NARRATIVE
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LPA Hiratsuka conducted this unannounced annual visit. LPA toured with Supervisor Marina Nagel. Administrator Merida Naverrete arrived during the visit.
This facility consists of one large common area with offices and a smaller common area to the right side of the main entrance. There are common restrooms in the rear right corner of the facility.
Staff training and several resident records were reviewed.
Multiple topics discussed.
No deficiencies cited.
SUPERVISORS NAME
:
Troy Ordonez
LICENSING EVALUATOR NAME
:
Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE
:
DATE:
01/16/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
01/16/2025
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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