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Facility Evaluation Report

Creekside Place, Petaluma07/29/2025Licence 496803441

Capacity6
Census6
Date signed07/30/2025 08:40:58 AM
Name of licensing program analystShannan Hansen
Name of licensing program managerBethany Moellers
The inspector’s account

License Program Analyst (LPA) Hansen arrived unannounced at 8:15AM to conduct an annual inspection of the facility. LPA met with staff/designee Danielle Nunez as Licensee/Administrator Kelly Sturgeon was not available. Facility is single story with 5 bedrooms that has a fire clearance by the Petaluma Fire Department granting 6 Non-Ambulatory of which 1 may be bedridden (rm 4). Hospice waiver granted for 4 residents. There is a total of 6 residents, 3 with a diagnostic of dementia. There is 1 resident currently on Hospice.

LPA toured the facility on 7/29/2025 at 8:30 AM with designee; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Exits were equipped with auditory devices. Fire Extinguisher was found to be last charged on 3/22/2025 at the time of the visit. Smoke detectors & combination carbon monoxide were found to be operational during the visit. Hot water temperature measured between 110.3 degrees F and 112.1 degrees F within Title 22 acceptable regulation of 105 to 120 degrees F in 2 of 2 resident’s bathrooms while touring facility on 7/29/2025. The facility serves residents with dementia and has a plan of operation for special care and programming. There was a sufficient supply of nonperishable and 7-day supply of perishable as required by Title 22 regulations. Food stored in the kitchen refrigerator were properly stored as per regulations on this day at the time of the visit. Facility oven and stove have protective mechanisms of buttons that must be held for over 5 seconds before heating element will turn on to prevent burns or fire, as per Title 22 regulations. Toxins are stored in a locked cabinet in the kitchen and under locked bathroom sink cabinets. Sharps are kept in locked kitchen drawer.

There was a supply of cleaners, hygiene products and paper products available for residents. The bathrooms designated for residents at the facility were supplied hand soap dispensers. Bathrooms contained necessary grab bars and slip-resistant mats, strips, or flooring in all bathtub and or shower floors as required by Title 22 Regulations. All bedrooms have lighting & appropriate furnishings. Continue on LIC809-C

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