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SU0002681 (2)
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2600 - Land Use Program
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SA-99-53
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SU0002681 (2)
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Entry Properties
Last modified
10/28/2020 3:59:53 PM
Creation date
9/6/2019 10:10:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0002681
PE
2633
FACILITY_NAME
SA-99-53
STREET_NUMBER
19171
Direction
E
STREET_NAME
MELLO
STREET_TYPE
AVE
City
RIPON
ENTERED_DATE
10/31/2001 12:00:00 AM
SITE_LOCATION
19171 E MELLO AVE
QC Status
Approved
Scanner
SJGOV\wng
Supplemental fields
FilePath
\MIGRATIONS\M\MELLO\19171\SA-99-53_VR-99-02\SU0002681\MISC.PDF
Tags
EHD - Public
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E� OF F4 <br /> 5 � <br /> 4 IA <br /> dG� J <br /> C9lIFO PNS <br /> State of California <br /> Department of Social Services <br /> Facility Number: 39030526 <br /> Effective Datd: 09/07/93 L • otal Capacity: 10' <br /> In accordance with applicable provisions of the Health and Safety Code of <br /> California, andrits rules and regulations: the Department of Social Services, hereby issues <br /> this License to <br /> GALVEZs JOSE's, MAMUYACv FLORENTINO G MA. IMMACULAD <br /> to operate and maintain a ADULT RESIDENTIAL <br /> Name of Facility <br /> TOWN G COUNTRY GUEST HOME <br /> 2829 S. D STREET, <br /> STOCKTON ICA 95206 <br /> This License is not transferable and is granted solely upon the following. <br /> AMBULATORY ONLY. AGES 18-59 YEARSt <br /> Client Groups Served: DEVELOP DISABLED <br /> Complaints regarding services provided in this facility should be directed to: <br /> SACRAMENTO RES. DISTRICT OFFICE (916) 574-2346 <br /> MARTHA LOPEZ <br /> Deputy Director, Authorize R hAresentative <br /> Community Care Licensing Division of Licensing Agency <br /> L-C nI 1"3) �Y <br /> POST IN A PROMINENT PLACE <br /> tllt� l9-1 <br />
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