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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525001919
Report Date: 05/31/2024
Date Signed: 05/31/2024 02:00:49 PM


Document Has Been Signed on 05/31/2024 02:00 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:ALOHA HOUSEFACILITY NUMBER:
525001919
ADMINISTRATOR:TIPPETTS, BARBARAFACILITY TYPE:
740
ADDRESS:13765 LISA WAYTELEPHONE:
(530) 529-1052
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY:6CENSUS: 4DATE:
05/31/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Barbara Tippetts - licensee / administratorTIME COMPLETED:
01:30 PM
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05/31/2024 01:00 PM A meeting was conducted today via TEAMS. The purpose of this meeting was to discuss the change of ownership of the facility. Present in the meeting today were Licensing Program Manager, Lauren Crocker, Licensing Program Analyst Rebecca Knight, and licensee/administrator Barbara Tippetts.

Items discussed during the meeting:
Obligation of current owner to ensure a smooth transition for residents during the Change of Ownership (CHOW) process.

If the home is sold during the CHOW the licensee must submit a copy of the lease back.

Change of Ownership Notification: A 30-day notification to the residents is required instead of 60 days, as per Health and Safety Section 1569.19.

Provide CCL with copies of all or any written notification served to the residents/responsible parties/Placement Agency regarding the change of ownership. Written notification should occur at least 30 days prior to the transfer of the property or business, or at the time a bona fide offer is made, whichever is longer.

Ensure all licensing fees are paid and up to date prior to closure.

Current Owner is still held accountable for any open complaints until the new owner has obtained a facility license.

Notify a prospective buyer in writing of the necessity to obtain a license if the buyer intends to continue operating the facility as a residential care facility for the elderly (Health and Safety Section 1569.19). Include a hard date that the current licensee will stop operating the facility.

Inform the prospective buyer that they need to submit an application for a license (Health and Safety Section 1569.19).

Licenses are Non-Transferable: The pending applicant must obtain a new license from the Department before the ownership of the facility can be transferred.

Current Owner Accountability: The current owner remains accountable for the facility until the new licensure is approved.
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 261-4966
LICENSING EVALUATOR NAME: Rebecca KnightTELEPHONE: (530) 356-2841
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2024
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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