Small board & care homeLicensed

Jd Residential-Evercare

4503 Sioux Ct, Shasta Lake, CA 96019

  • Licensed for 6 residents
  • Serves residents with dementia
  • Hospice waiver

About Jd Residential-Evercare

Jd Residential-Evercare is a small, home-like residential care facility for the elderly in Shasta Lake, California, licensed by the California Department of Social Services to care for up to 6 residents. It has held its current license for 1 year. CDSS lists it as serving residents with dementia. It holds a hospice waiver, so residents can receive hospice care without moving.

Licensing & inspections

Official CDSS report
License status
Licensed
Facility number
455920269
Licensed capacity
6
Licensed since
April 29, 2025
Last state visit
February 19, 2026
Inspection visits
1
Recent routine and required inspections
Complaint visits
0
Visits to investigate complaints
Type A citations
0
Immediate risk to health, safety, or rights
Type B citations
0
Could become a risk if not corrected
Licensee:
Jd Residential Services, Inc
Administrator:
Potter, Dominique
CDSS office:
SACRAMENTO NORTH ASC
Serves:
RCFE / Dementia

State license notes: Age range 60 and over. Approved fire clearance for six(6) of which two(2) may be non-ambulatory. Non-ambulatory cleared in bedroom #3. Waiver/granted for hospice care for (2).

Data from CDSS Community Care Licensing, last checked November 3, 2026.

Location

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