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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700524
Report Date: 09/28/2022
Date Signed: 09/28/2022 10:26:13 AM

Document Has Been Signed on 09/28/2022 10:26 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:VRETCHEN MARIE CAREFACILITY NUMBER:
342700524
ADMINISTRATOR:GARCIA, VRETCHEN MARIE JFACILITY TYPE:
740
ADDRESS:7232 CIRCLET WAYTELEPHONE:
(916) 242-8999
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 6CENSUS: 0DATE:
09/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Vretchen Marie Garcia- Administrator TIME COMPLETED:
10:40 AM
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Licensing Program Analyst (LPA) Sarena Keosavang arrived at the facility unannounced on 9/28/2022 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with Vretchen Marie Garcia, Administrator, and explained the purpose of the visit. LPA ensured to apply hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Masks.

The facility currently has no residents.

LPAs toured the facility. Areas toured include but are not limited to: 5 bedrooms and 3 bathrooms for residents, common area, dining room, kitchen, and outdoor area. In the areas toured no immediate health, safety, or personal rights violations were observed. LPAs and Administrator completed the infection control domain and facility was found to be in substantial compliance at this time.

No deficiencies are being cited.

Exit interview conducted and copy of report left at the facility.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Sarena Keosavang
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2022
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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