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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345003020
Report Date: 04/09/2024
Date Signed: 04/09/2024 03:42:13 PM

Document Has Been Signed on 04/09/2024 03:42 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:CARMICHAEL ESTATES NO. 1FACILITY NUMBER:
345003020
ADMINISTRATOR/
DIRECTOR:		MCFADDEN, REBECCAFACILITY TYPE:
740
ADDRESS:5228 EL CAMINO AVETELEPHONE:
(406) 533-8372
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 6CENSUS: 0DATE:
04/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:49 PM
MET WITH:Rebecca McFaddenTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a required annual inspection. LPA met with Administrator, Rebecca McFadden, and explained the purpose of the visit.

LPA was informed the facility is currently not in operation as it is in renovation. Administrator stated facility has been vacant since September 2023. LPA observed facility to be vacant, Administrator confirm there is no residents in care.

Post licensing inspection will be conducted once facility is in operation with residents in care.

No deficiencies cited.

Exit interview conducted and a copy of the report was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/09/2024
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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