Senior Care Records.

Facility Evaluation Report

Crown Manor, Elk Grove01/21/2022Licence 342700439

Capacity4
Census3
Date signed01/21/2022 09:44:12 AM
The inspector’s account

On 1/21/2022 at 8:40 am, Licensing Program Analyst (LPA) Tung Truong arrived at this facility unannounced to conduct an annual inspection visit. LPA met with Administrator Rowena Villanueva and explained the purpose of today’s visit.

Administrator holds current certification #6013029735 and expires on 10/4/2022. The facility is licensed to serve up to four (4) clients (3 ambulatory and 1 non-ambulatory). There are currently 3 clients who reside at this facility. LPA toured the facility with Rowena Villanueva on 1/21/2022 at 8:55 am.

LPA inspected the physical plant including but not limited to the common area, kitchen, dining area, client bedrooms, client bathrooms, laundry room and outside courtyards of the facility to ensure compliance with Title 22 regulations. LPA observed the facility is clean and in good repair. LPA observed sufficient furniture and lighting throughout the facility. LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. The hot water temperature was observed to be 110 degrees Fahrenheit, which is within the required regulation of 105 to 120 degrees Fahrenheit. Facility thermostat observed at 68 degrees Fahrenheit. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed knives and toxins to be locked away and inaccessible to clients. Smoke and carbon detectors were in good repair. Fire extinguisher and first aid kit was up to date. LPA checked medication storage and found medication to be locked away and inaccessible to clients. LPA also conducted the infection control domain tool.

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