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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565801541
Report Date: 07/26/2022
Date Signed: 07/27/2022 09:09:18 AM

Document Has Been Signed on 07/27/2022 09:09 AM - 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, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:FINEST LIVING AT CRESTWOODFACILITY NUMBER:
565801541
ADMINISTRATOR:ADELAIDA G. CRUZFACILITY TYPE:
740
ADDRESS:225 CRESTWOOD AVENUETELEPHONE:
(805) 212-8303
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY: 6CENSUS: 6DATE:
07/26/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Adelaida CruzTIME COMPLETED:
10:25 AM
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An Office Meeting was held via Microsoft Teams. The purpose of the meeting is to discuss the Decision and Order dated July 12, 2022. In attendance are: Licensing Program Manager (LPM) Kristin Heffernan, Licensing Program Analyst (LPA) JoAnn Rosales and Licensee Representative/Administrator Adelaida Cruz.

During today's meeting LPM reviewed the Decision and Order, and ensured the licensee understands that S1 is prohibited from being a licensee, owning a beneficial ownership interest of 10 percent or more in a licensed facility, or being an Administrator, Officer, Director, Member, or Manager of a licensee or entity controlling a licensee, and, further, from employment in, presence in, and contact with clients of, any facility licensed by the Department or certified by a licensed foster family agency, or any resource family home, for the remainder of S1's life, unless and until S1 successfully petitions for reinstatement pursuant to Government Code section 11522.

Licensee stated that S1 has not worked at the facility since 2014. Licensee stated that S1 worked less than a month at the facility and not in the capacity of a caregiver. Licensee stated that S1 never worked at their other licensed facility Finest Living at Arcade #565801730. Licensee is aware that the effective date of the Decision and Order is July 22, 2022 and that the order is to be posted in common areas of both of their facilities.

Exit interview conducted, today's report was reviewed and emailed to the Administrator.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2022
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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