<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
347002258
Report Date:
07/09/2024
Date Signed:
07/09/2024 03:18:00 PM
Document Has Been Signed on
07/09/2024 03:18 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 SOUTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
PARADISE QUALITY GUEST HOME
FACILITY NUMBER:
347002258
ADMINISTRATOR/
DIRECTOR:
AFALLA, BEATRIZ L.
FACILITY TYPE:
740
ADDRESS:
3428 PAGEANT DRIVE
TELEPHONE:
(916) 366-1874
CITY:
SACRAMENTO
STATE:
CA
ZIP CODE:
95826
CAPACITY:
6
CENSUS:
6
DATE:
07/09/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
02:55 PM
MET WITH:
Beatriz Afalla
TIME VISIT/
INSPECTION COMPLETED:
03:30 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
Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski met with facility administrator Beatriz Afalla and explained the purpose of the visit.
LPA Moleski provided technical assistance regarding fire clearance requirements.
No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Afalla.
SUPERVISORS NAME
:
Stephen Richardson
LICENSING EVALUATOR NAME
:
Vincent Moleski
LICENSING EVALUATOR SIGNATURE
:
DATE:
07/09/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/09/2024
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