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Facility Evaluation Report

Adams Residential Care Services LLC, Citrus Heights04/08/2026Licence 345002847

Capacity6
Census4
Date signed04/08/2026 02:40:37 PM
Name of licensing program analystSabrina Calzada
Name of licensing program managerLauren Crocker
The inspector’s account

Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection following receipt of a Facility Action Report (FAR) from Alta Regional Center. LPA met with Luzvminda Cailing, Administrator Designee, and stated the reason for today's inspection. Administrator Designee, Adam Dickey, arrived shortly to the facility. LPA discussed the following (4) areas brought to the Department's attention:

Residential Behavioral Consultation Logs- did not identify direct supervision was occurring from July 2025 through December 2025. LPA observed logs to be complete, correct and signed by the individual providing the direct supervision. Administrator Designee, Adam, stated that it is a fairly new requirement that 10% of the hours must be provided in person.

Amended Individual Program Plan (IPP) (August 2025) was not on file for client (C1). Service Coordinator, Melissa Sipsy, provided a copy about a week later, which is on file. Administrator Designee, Adam, provided a copy of an Addendum to the Individual Program Plan (IPP), dated 8/22/2024, that (C1) will live at the facility for as long as placement is deemed appropriate through September 2025.

Medication Reason For Use (MRFU) letter was updated on 2/26/2026 for client (C2) to clarify frequency of medication, Bengay. LPA observed the PRN letter was updated by the physician for Benzonatate and Naproxen on 2/26/2026.

Centrally Stored Medication Destruction Record (LIC622 ) was updated for client (C2) following the review to add medication, Hydroxyzine 25 mg, as received on 11/17/2025 and on 1/9/2026.

Medication Administration Record (MAR) was updated for client (C1) to reflect the correct prescription for Docusate- 2x/day as needed. The Pharmacy updated the prescription to match the doctor's orders.

All corrections for the above were provided to the Regional Center by 3/6/2026. The Department was notified of all corrections being completed on 3/11/2026 and sanctions were lifted on 3/9/2026.

Exit interview. There are no deficiencies issued in this report. Copy of report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction