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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920085
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:25:58 PM

Document Has Been Signed on 01/16/2025 12:25 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:ZEPHYR LOVING CARE LLCFACILITY NUMBER:
315920085
ADMINISTRATOR/
DIRECTOR:		ROMERO, RUSSELFACILITY TYPE:
740
ADDRESS:1008 ZEPHYR CTTELEPHONE:
(279) 900-8051
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 6DATE:
01/16/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 1/16/24, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit while met with caregiver. Administrator was contacted and arrived to assist.

On 1/16/25, the department received a cross reported regarding ongoing issues of R1's representative failure to pay fees.

LPA and Administrator discussed the issue and options available. Licensee will be in touch with a social worker to continue to resolve the issue. R1 is stable and receiving the assistance needed.

LPA discussed new regulation changes with Administrator, provided flier and how to accesses additional information.

As a result of today’s inspection, no deficiencies were noted.



Report reviewed. Copy of report and appeal rights provided
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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