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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003296
Report Date: 12/18/2024
Date Signed: 12/18/2024 02:45:28 PM

Document Has Been Signed on 12/18/2024 02:45 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:JD PARAN GUEST HOME IIFACILITY NUMBER:
347003296
ADMINISTRATOR/
DIRECTOR:		PARAN, JINKYFACILITY TYPE:
740
ADDRESS:9458 NEWINGTON WAYTELEPHONE:
(916) 684-5959
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 6CENSUS: 6DATE:
12/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:15 PM
MET WITH:Jinky ParanTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to conduct a case management visit. LPA Moleski spoke with facility administrator Jinky Paran over the phone and explained the purpose of the visit. Paran said that staff member Teresita Heriales could sign this report in her absence.

This facility received a new fire clearance on 12/4/24. During this visit, LPA Moleski provided this facility with a new license reflecting the updated fire clearance. LPA Moleski retrieved this facility's old license.

No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Heriales.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Vincent Moleski
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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