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SU0002681 (2)
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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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OFFF � � an <br /> Uro a <br /> State of California <br /> Department of Social Services <br /> Facility Number: 390305260 <br /> Effective Date: 09/07/930 Total Capacity: 12 <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 /> GALVEZ• JOSE; MAMUYAC9 FLORENTINO E MA. IMMACULAD <br /> to operate and maintain a ADULT RESIDENTIAL <br /> Name of Facility <br /> TOWN E COUNTRY GUEST HOME <br /> 2829 S. D STREET, <br /> STOCKTON CA 95206 <br /> This License is not transferable and is granted solely upon the fe:lowing: <br /> AMBULATORY ONLY. AGES 18-59 YEARS. <br /> Client Groups Served: DEVELOP DISABLED <br /> Complaints regarding services provided in this facility should be directed to <br /> SACRAMENTO DISTRICT OFFICE (916) 574-•2346 <br /> MARTHA i npF7 ��C� <br /> Deputy Director, Authorized Repres n ative <br /> Community Care Licensing Division of Licensing Agency <br /> C MM 4431 <br /> POST IN A PROMINENT PLACE <br />
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