<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920103
Report Date: 12/26/2024
Date Signed: 12/26/2024 03:12:01 PM

Document Has Been Signed on 12/26/2024 03:12 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: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:
12/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On December 26, 2024, Licensing Program Analyst (LPA) Cassie Yang arrived at the facility to conduct a case management visit to complete COMP III. LPA met with Administrator and explained the purpose of the visit.

As requested, Comp III was conducted with Administrator.

LPA provided Administrator a copy of LIC 311F and CCR 87632 Hospice Waiver.

Interview interview, a copy of report was provided.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 12/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1