Facility Evaluation Report, 06/10/2025 — Forever Sarahs Elderly Care Corp, Santa Rosa CA

Licensing Program Analyst (LPA) Christi Coppo arrived unannounced to conduct a POC case management visit and was greeted by caregiver. LPA called licensee to advise purpose of LPA visit, but licensee did not answer LPA phone call, the voicemail box was full so LPA could not leave a message.

On 5/30/25 LPA conducted a POC visit and reissued citations for deficiencies of regulations: 85064(b), 80075(f ), 80069(b) , 80075(k)(1 ), 85088(c)(4)(B ), 80077.3(a)(3)(C ), 80066(e) , 80087(g) . As of today, 6/10/25 CCL has not received plans of correction for these deficiencies. Therefore, civil penalties are being assessed for failure to correct for the period of 6/3/25 through 6/10/25 at $100 per day for a total of $800 each, respectively. The $100 per day civil penalty will continue to accrue until the deficiency is cleared.

On 5/30/25 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 5/3/25 through 5/30/2025 at $100 per day for a total of $2800. Also on 5/30/25 the licensee was issued a civil penalty for failure to correct deficiencies 80062(a)(1) and 80076(a)(1) for the period of 5/3/25 through 5/30/2025 at $100 per day for a total of $2800 , each, respectively.

As of today 6/10/25, 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 5/31/25 through 6/10/2025 at $100 per day for a total of $1100. The $100 per day civil penalty will continue to accrue until the deficiency is cleared. As of today 6/10/25, 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 5/31/25 through 6/10/2025 at $100 per day for a total of $1100 for each respective deficiency . The $100 per day civil penalty will continue to accrue until the deficiency is cleared.