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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003628
Report Date: 01/28/2025
Date Signed: 01/28/2025 12:31:13 PM

Document Has Been Signed on 01/28/2025 12:31 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:SUGAR MAPLE CARE HOMEFACILITY NUMBER:
347003628
ADMINISTRATOR/
DIRECTOR:		SOTEA, FLORICAFACILITY TYPE:
740
ADDRESS:6737 SUGAR MAPLE WAYTELEPHONE:
(916) 222-2022
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 5DATE:
01/28/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Florica SoteaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On January 28, 2025, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced to conduct a collateral visit to conduct an interview with Resident #1 (R1). LPA met with Administrator, and informed her the purpose for the visit.

During today's visit, LPA spoke with R1 on an issue that was not related to this facility.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Exit Interview conducted and a copy of the report was provided to Administrator.
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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