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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002884
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:12:11 PM

Document Has Been Signed on 06/29/2023 02:12 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:CARE HORIZONS IIFACILITY NUMBER:
345002884
ADMINISTRATOR:IORDACHE, DRAGOS ADRIANFACILITY TYPE:
740
ADDRESS:6640 CARE LANETELEPHONE:
(916) 229-7154
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 6CENSUS: 5DATE:
06/29/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Adrian IordacheTIME COMPLETED:
02:15 PM
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On 6/29/23, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit and met with licensee.

LPA conducted a health and safety visit.

All residents were receiving appropriate care. The home is clean and in good condition.

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



Report reviewed. Copy of report provided
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
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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