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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002913
Report Date: 10/09/2024
Date Signed: 10/09/2024 09:28:22 AM

Document Has Been Signed on 10/09/2024 09:28 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
FACILITY NAME:A LOVING ARM HOME LLCFACILITY NUMBER:
315002913
ADMINISTRATOR/
DIRECTOR:		INVIERNO, VERONICA R.FACILITY TYPE:
740
ADDRESS:409 GLIMMER PLACETELEPHONE:
(916) 872-0384
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY: 6CENSUS: 6DATE:
10/09/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:50 AM
MET WITH:Veronica Invierno, AdministratorTIME VISIT/
INSPECTION COMPLETED:
09:45 AM
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Licensing Program Analyst (LPA) Bethany Mirlohi arrived unannounced to conduct a POC visit. LPA met with Administrator Veronica Invierno during today's inspection.

During today's inspection LPA toured the facility, reviewed paperwork, and observed the POC's cited on 9/19/24 have been cleared. LPA provided administrator with letter of clearance and a copy of report was provided.

Exit interview was conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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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