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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
045002773
Report Date:
12/17/2024
Date Signed:
12/17/2024 09:57:16 AM
Document Has Been Signed on
12/17/2024 09:57 AM
- It Cannot Be Edited
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
ROSELEAF OROVILLE
FACILITY NUMBER:
045002773
ADMINISTRATOR/
DIRECTOR:
BAXTER, STACEY
FACILITY TYPE:
740
ADDRESS:
1900 20TH ST
TELEPHONE:
(530) 538-8200
CITY:
OROVILLE
STATE:
CA
ZIP CODE:
95965
CAPACITY:
60
CENSUS:
DATE:
12/17/2024
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:
Stacey Baxter - administrator
TIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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12/17/2024 09:35 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced and met with administrator Stacey Baxter. The purpose of the visit was to conduct an unannounced case management visit to check room temperatures related to a previously substantiated complaint.
LPA Knight took temperatures in the lower hall where there are no residents. These rooms registered below Title 22 temperature requirements. The facility has hired a heating /air conditioning company to make required repairs and they are waiting to receive parts to complete the repair of the system. The residents who did live in this area of the facility were moved to the middle and upper halls of the facility in November 2024. LPA will come back and inspect after the repairs have been completed. No residents will live in this portion of the facility until this follow-up inspection has confirmed that temperatures meet Title 22 requirements.
LPA Knight took temperatures in ten random rooms in the middle and upper halls of the facility. Those rooms all registered between 72 and 79 degrees which meets Title 22 requirements.
No deficiencies were cited during the visit. Exit interview completed. Copy of report was provided to administrator Stacey Baxter.
SUPERVISORS NAME
:
Lauren Crocker
LICENSING EVALUATOR NAME
:
Rebecca Knight
LICENSING EVALUATOR SIGNATURE
:
DATE:
12/17/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
12/17/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
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