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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
345002850
Report Date:
12/27/2024
Date Signed:
12/27/2024 12:38:18 PM
Document Has Been Signed on
12/27/2024 12:38 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:
ECLIPSE HOME CARE II
FACILITY NUMBER:
345002850
ADMINISTRATOR/
DIRECTOR:
SAEGER, MAGDALENA
FACILITY TYPE:
740
ADDRESS:
137 YANKTON ST.
TELEPHONE:
(916) 985-8851
CITY:
FOLSOM
STATE:
CA
ZIP CODE:
95630
CAPACITY:
6
CENSUS:
6
DATE:
12/27/2024
TYPE OF VISIT:
Post Licensing
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:
Melissa Robinson and Magdalena Saeger
TIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a required annual inspection. LPA met with Administrator and explained the purpose of the visit.
LPA is conducting an annual inspection today but this report is being generated to clear the Post-Licensing inspection in the system.
There are no citations issued on this report.
Exit interview. Copy of report was provided.
SUPERVISORS NAME
:
Anthony Perez
LICENSING EVALUATOR NAME
:
Cassie Yang
LICENSING EVALUATOR SIGNATURE
:
DATE:
12/27/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/27/2024
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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