City of Sacramento
City Council - 2PM Report
915 I Street Sacramento, CA 95814
www.cityofsacramento.org
File ID: 2025-01666 10/7/2025
Triple R Adult Day Program Licensee Name Change
File ID: 2025-01666
Location: District 2, 4, 7
Recommendation: Pass a Motion: 1) authorizing Youth, Parks, and Community Enrichment staff to submit the attached forms (in substantially the same form) and take any other actions necessary to update the licensee name for Triple R Adult Day programs from “Triple R” to “City of Sacramento.
Contact: Katie Houser, Recreation Manager, (916) 808-6046, [email protected], Youth, Parks, and Community Enrichment Department (YPCE) Presenter: None
Attachments:
1-Description/Analysis
2-Administrative Organization Form-North Sacramento Site 3-Administrative Organization Form-Midtown Site
4-Administrative Organization Form-South Land Park Site Description/Analysis
Issue Detail: The Department of Youth, Parks, and Community Enrichment (YPCE) is requesting Council approval to submit a licensee name change to the State of California, Department of Social Services from “Triple R” to “City of Sacramento” to accurately reflect the agency approving operation of the program. YPCE operates three licensed adult day programs citywide to approximately 60 families with 7,500 days of service, providing affordable and reliable respite care for families taking care of a loved one with dementia.
Policy Considerations: The recommendation in this report allows the city to meet State of California Licensing guidelines to continue operation of the Triple R program.
Economic Impacts: None.
Environmental Considerations: None.
File ID: 2025-01666 10/7/2025
Sustainability: None
Commission/Committee Action: Not applicable.
Rationale for Recommendation: Approval of the recommendation allows the city to be in compliance with State of California, Department of Social Services licensing requirements that are required to operate the Triple R program and accurately labels the authorized operating agency as the City of Sacramento.
Financial Considerations: Not applicable.
Local Business Enterprise (LBE): None.
11. List all Directors (Corporations)/Managers and Managing Members (LLC) Name
(Attach Sheet for additional space)
II. PUBLIC AGENCY
1. Check type of public agency:
2. Agency providing services:
Mailing Address & City & Zip Code
D Federal D State D County
Telephone No. Term Expires
Ill City D Other, specify below
Name: City of Sacramento Address: 915 I Street Sacramento, Ca 95814
CITY/STATE
Mailing Address: City of Sacramento, Hart Senior Center, 915 27th Street, Sacramento, Ca 95816 Contact Person: Chantell Albers
3. District or Area to be served: (attach map if necessary) Title: Program Supervisor
Specify geographic area:
4. Attach copy of Resolution or legal document authorizing this application.
Ill. PARTNERSHIPS
Attach a copy of partnership agreement (attach additional sheet if necessary) 1st Partner D General Name
D Limited Principal Business Address
2nd Partner D General Name
D Limited Principal Business Address
3rd Partner D General Name
D Limited Principal Business Address
4th Partner D General Name
D Limited Principal Business Address
Contact Person: ____________ _ Title: _____________ _
IV. OTHER ASSOCIATIONS
CITY/STATE/ZIP CODE
Phone No.: 916-808-5462
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
Telephone No.: _______ _
Other associations must also provide a similar list of persons legally responsible for the organization, contact person, appropriate legal documents which set forth legal responsibility of the organization and accountability for operating the facility.
11. List all Directors (Corporations)/Managers and Managing Members (LLC) Name
(Attach Sheet for additional space)
II. PUBLIC AGENCY
1. Check type of public agency:
2. Agency providing services:
Mailing Address & City & Zip Code
D Federal D State D County
Telephone No. Term Expires
Ill City D Other, specify below
Name: City of Sacramento Address: 915 I Street Sacramento, Ca 95814 Mailing Address: 915 27th Street, Sacramento, Ca 95816
Contact Person: Chantell Albers
3. District or Area to be served: (attach map if necessary) Title: Program Supervisor
Specify geographic area:
4. Attach copy of Resolution or legal document authorizing this application.
Ill. PARTNERSHIPS
Attach a copy of partnership agreement (attach additional sheet if necessary) 1st Partner D General Name
D Limited Principal Business Address
2nd Partner D General Name
D Limited Principal Business Address
3rd Partner D General Name
D Limited Principal Business Address
4th Partner D General Name
D Limited Principal Business Address
Contact Person: ____________ _ Title: _____________ _
IV. OTHER ASSOCIATIONS
CITY/STATE
CITY/STATE/ZIP CODE
Phone No.: 916-808-5462
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
Telephone No.: _______ _
Other associations must also provide a similar list of persons legally responsible for the organization, contact person, appropriate legal documents which set forth legal responsibility of the organization and accountability for operating the facility.
11. List all Directors (Corporations)/Managers and Managing Members (LLC) Name
(Attach Sheet for additional space)
II. PUBLIC AGENCY
1. Check type of public agency:
2. Agency providing services:
Mailing Address & City & Zip Code
D Federal D State D County
Telephone No. Term Expires
Ill City D Other, specify below
Name: City of Sacramento Address: 915 I Street Sacramento, Ca 95814 Mailing Address: 915 27th Street, Sacramento, Ca 95816
Contact Person: Chantell Albers
3. District or Area to be served: (attach map if necessary) Title: Program Supervisor
Specify geographic area: . .
4. Attach copy of Resolution or legal document authorizing this application.
Ill. PARTNERSHIPS
Attach a copy of partnership agreement (attach additional sheet if necessary) 1st Partner D General Name
D Limited Principal Business Address
2nd Partner D General Name
D Limited Principal Business Address
3rd Partner D General Name
D Limited Principal Business Address
4th Partner D General Name
D Limited Principal Business Address
Contact Person: ____________ _ Title: _____________ _
IV. OTHER ASSOCIATIONS
CITY/STATE
CITY/STATE/ZIP CODE
Phone No.: 916-808-5462
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
TELEPHONE NUMBER
CITY/STATE
Telephone No.: _______ _
Other associations must also provide a similar list of persons legally responsible for the organization, contact person, appropriate legal documents which set forth legal responsibility of the organization and accountability for operating the facility.