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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002794
Report Date: 04/28/2023
Date Signed: 04/28/2023 02:47:02 PM

Document Has Been Signed on 04/28/2023 02:47 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME:LOVE & LIGHTFACILITY NUMBER:
315002794
ADMINISTRATOR:ROMANOVA, LARISAFACILITY TYPE:
740
ADDRESS:6032 CRATER LAKE DR.TELEPHONE:
(916) 749-3181
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 5DATE:
04/28/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Larisa Romanova and Doru Juganaru, Administratoras TIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived at the facility unannounced to conduct a Required-1 Year Inspection utilizing the full inspection care tool.

This report is being created in the system to clear the post-licensing inspection that was not previously conducted. A separate report was created to document the required annual inspection.

Administrator confirmed the first resident moved in around July 2022.

There are no deficiencies cited in this report.

Exit interview. Copy of report provided to Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2023
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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