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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 585920135
Report Date: 05/31/2024
Date Signed: 06/17/2024 10:23:30 AM

Document Has Been Signed on 06/17/2024 10:23 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:BOSWELL CARE HOMEFACILITY NUMBER:
585920135
ADMINISTRATOR/
DIRECTOR:		AGUIRRE, LEAHFACILITY TYPE:
735
ADDRESS:1910 BOSWELLTELEPHONE:
(858) 717-6817
CITY:PLUMAS LAKESTATE: CAZIP CODE:
95961
CAPACITY: 4CENSUS: 0DATE:
05/31/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Leah Aguirre TIME VISIT/
INSPECTION COMPLETED:
01:00 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
On 5/31/2024 LPA Tryon visited the facility to conduct a pre-licensing visit. LPA met with applicants Leah Aguirre and Maxim Agati.
LPA toured the home, which is brand new construction. The home has 5 bedrooms; one staff room and four single resident rooms. The home is very nice, well-furnished with required furniture such as bed, night stand, light, chair, dresser, closet, etc. The rest of the house is nicely furnished with new furniture. There is a covered patio in back off the dining area with furniture.
The house has all new appliances, dishes, pots and pans, etc.
Locked storage is available under the kitchen sink for cleaners/chemicals; and in a locked kitchen cabinet for medications. Refrigerator/freezer are at appropriate temperatures. Washer/dryer installed. All plumbing is brand new.
Combination smoke and carbon monoxide detectors installed in hallways and all bedrooms. The house has fire sprinklers installed. Fire extinguisher present and charged.

LPA reviewed the Pre-licensing CARE Tool with applicants.

LPA is waiving the requirement for ARF Orientation Component III at this time, as both have been licensee/administrators for other homes they own.

At this time, the facility appears to meet Title 22 Regulations and the Health and Safety Code.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
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)
Page: 1 of 1