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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002935
Report Date: 08/08/2023
Date Signed: 08/08/2023 11:26:03 AM

Document Has Been Signed on 08/08/2023 11:26 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:TRINITY HOME FOR SENIORFACILITY NUMBER:
315002935
ADMINISTRATOR:CADORNA, JULIUSFACILITY TYPE:
740
ADDRESS:5405 SAGE CTTELEPHONE:
(916) 251-7689
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 6CENSUS: 0DATE:
08/08/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Julius and Rosmarie Cadorna, Licensees TIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Bethany Mirlohi and Licensing Program Manager (LPM) met with licensee and administrator Julius and Rosmarie Cadorna.

CCL conducted an office visit to review LIC200 and clarify who is running the day to day operations of this facility. Licensees stated they rent the home and have control of property. Licensee's run the day to day operation, however they do not have any clients residing within the home at this time.

Exit interview and copy of report provided to licensees.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Bethany Mirlohi
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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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