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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803974
Report Date: 04/19/2023
Date Signed: 04/26/2023 03:57:02 PM

Document Has Been Signed on 04/26/2023 03:57 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:L & S GENTLE CARE IIFACILITY NUMBER:
486803974
ADMINISTRATOR:PADAMA, SAMUELFACILITY TYPE:
740
ADDRESS:778 APPALOOSA CTTELEPHONE:
(707) 846-1100
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 6CENSUS: 6DATE:
04/19/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Licensees Imelda and Samuel PadamaTIME COMPLETED:
12:30 PM
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The Department of Social Services (DSS) Community Care Licensing Division (CCL) Santa Rosa Regional Office held a meeting by virtual calling with the Department of Labor (DOL) and L & S Gentle Care II on 04/19/2023. The purpose of the meeting was to discuss the most recent findings from the DOL investigation of L & S Gentle Care II facility.
Present in the meeting were:
    Department of Labor (DOL) Wage & Hour Division (WHD):
    Investigators Patricia Canites and Michael DeLaTorre.

    Department of Social Services (DSS) Community Care Licensing Division (CCL):
    Regional Manager Carla Nuti-Martinez, Licensing Program Manager Kim Mota, and Licensing Program Analyst Karina Canela.

    Licensee Imelda Padama and Licensee/Administrator Samuel Padama.


DSS CCL to schedule a Non-Compliance Conference (NCC) with L & S Gentle Care II facility

No citations issued at this time


*A copy of this report was emailed to Administrator; signature in file.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Karina Canela
LICENSING EVALUATOR SIGNATURE: DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/19/2023
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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