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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920023
Report Date: 12/18/2024
Date Signed: 12/18/2024 03:32:56 PM

Document Has Been Signed on 12/18/2024 03:32 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:DAD'S PLACE, INC.FACILITY NUMBER:
315920023
ADMINISTRATOR/
DIRECTOR:		CHESTER, TYLERFACILITY TYPE:
740
ADDRESS:8100 HORSESHOE BAR RD.TELEPHONE:
(530) 718-0932
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY: 6CENSUS: 5DATE:
12/18/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Staff - Natalie ChesterTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 12/18/2024 Licensing Program Analysts (LPAs) Graham Gunby and Cheyenne Ratajczak arrived unannounced to conduct a case management-health and safety visit. LPAs met with staff Natalie Chester and explained the purpose of the visit. Natalie called Administrator Tyler Chester who was able to join the visit via Telephone. Administrator Tyler gave permission for Natalie to sign the report.

During time of visit five (5) resident were present at the facility. LPAs observed there was 2-day perishable, 7-day non-perishable amount of food available. LPAs observed resident medications were being stored properly and being dispensed daily to residents. No immediate health, safety, or personal rights violations were observed.

LPA Gunby requested Administrator to send updated copies of the following by 12/19/2024.
  • LIC 500
  • Control of property
  • Stock Certificate
  • Administration Certificate - received
  • LIC 308

No deficiencies cited during today's visit.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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