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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920067
Report Date: 11/19/2024
Date Signed: 11/19/2024 10:30:10 AM

Document Has Been Signed on 11/19/2024 10:30 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:LOVE YOU DADFACILITY NUMBER:
315920067
ADMINISTRATOR/
DIRECTOR:		GERGI, EDUARDFACILITY TYPE:
740
ADDRESS:5024 SOUTHSIDE RANCH RDTELEPHONE:
(916) 807-4319
CITY:ROCKLINSTATE: CAZIP CODE:
95677
CAPACITY: 6CENSUS: 6DATE:
11/19/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Administrator - Eduard GergiTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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
Licensing Program Analysts (LPAs) Graham Gunby and Cheyenne Ratajczak arrived on Tuesday November 19, 2024 to conduct the unannounced annual inspection.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPAs reviewed client (4) and staff (2) files. All client files contained the required paperwork. All staff files contained the required paperwork and training.

LPAs and Administrator Eduard toured the facility together to ensure the health and safety of clients in care. The areas toured included bedrooms (5), kitchen, bathrooms, laundry room, front yard and back yard. All chemicals, toxins and sharps were kept locked and inaccessible to clients. Facility has (1) fire extinguisher in the entry. In the areas toured, there were no health or safety violations observed.

No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the Administrator.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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