Senior Care Records.

Facility Evaluation Report

Forever Sarahs Elderly Care Corp, Santa Rosa02/21/2025Licence 496804038

Capacity4
Census2
Date signed02/21/2025 03:18:54 PM
The inspector’s account

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a POC case management visit and was greeted by caregiver. Licensee Jenero Jefferson was not available to come to the facility, was not available by phone and their voicemail box was full, so LPA could not leave a message. LPA sent text to licensee to advise purpose of visit. Licensee responded to text and asked LPA to "please let me know what needs to be corrected." LPA responded to text message stating "call me and I will explain all the corrections or you can read the reports and citations I left here on 2/13/25 and that if you'd like to call Ill be here for about another half an hour so." LPA then called Jenero again and this time could leave a voicemail.

On 2/13/25 LPA conducted a Case Management visit at which the licensee was issued a civil penalty for failure to correct deficiency HSC 1562.2(b)(1), for the period of 1/4/25 through 2/13/2025 at $100 per day for a total of $4200. Also on 2/13/25 the licensee was issued a civil penalty for failure to correct deficiencies 80062(a)(1) and 80076(a)(1) for the period of 1/4/25 through 2/13/2025 at $100 per day for a total of $4200 , each, respectively.

As of today 2/21/25, CCL has not received a plan of correction for deficiency of Health and safety Code (HSC) 1562.2(b)(1). Therefore, CCL is issuing a civil penalty for failure to correct deficiency of HSC 1562.2(b)(1) for the period of 2/14/25 through 2/21/2025 at $100 per day for a total of $800. The $100 per day civil penalty will continue to accrue until the deficiency is cleared. As of today 2/21/25, CCL has not received a plan of correction for deficiencies of regulations 80062(a)(1) and 80076(a)(1), respectively. Therefore, CCL is issuing a civil penalty for failure to correct deficiencies 80062(a)(1) and 80076(a)(1) for the period of 2/14/25 through 2/21/2025 at $100 per day for a total of $800 for each respective deficiency . The $100 per day civil penalty will continue to accrue until the deficiency is cleared.

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