Facility Evaluation Report

Licensing Program Analysts (LPAs) Yang and Mikkelson arrived unannounced at the facility to conduct a case management visit regarding a deficiency LPAs observed. LPAs met with caregiver who then contacted Administrator who then arrived to the facility shortly afterwards.

During LPAs visit, LPAs observed S1 to be working alone with residents in care. LPAs were informed S1 has been working at the facility since April 30, 2024. Based on file review, LPAs did not observe S1 to be associated to facility roster on Guardian. LPAs completed LIC 9182 with Administrator's signature to transfer S1's association to the facility.

LPAs and Administrator discussed fire clearance as Room 1 and Room 3 are approved for ambulatory only. LPAs reminded Administrator that residents with non-ambulatory status due to physical and/or mental condition cannot reside in Room 1 and Room 3 until cleared by Sacramento Metro Fire Department. Additionally, LPAs reminded facility that based on State Marshal laws and regulation, fire door are to remain closed at all times.

Deficiencies cited and civil penalty assessed. Please see LIC 809-D.

Exit interview conducted and a copy of the report and appeal rights was provided.