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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920103
Report Date: 09/10/2024
Date Signed: 09/10/2024 11:06:06 AM

Document Has Been Signed on 09/10/2024 11:06 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:SOLENZA HOME CAREFACILITY NUMBER:
345920103
ADMINISTRATOR/
DIRECTOR:		ABEBE, RAHELFACILITY TYPE:
740
ADDRESS:5525 BARBARA WAYTELEPHONE:
(916) 248-0338
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 6CENSUS: 0DATE:
09/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:05 AM
NARRATIVE
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Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management visit to complete COMP III. LPA met with Licensee, Rahel Abebe, and explained the purpose of the visit.

Comp III was conducted.

LPA and Licensee discussed that facility is pending construction for a change of ambulatory status. LPA will be notified once construction has been completed, new LIC 200 and facility sketch will be provided to LPA for a new ambulatory status request.

Interview interview, a copy of report will be emailed to Licensee.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2024
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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