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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125000579
Report Date: 03/25/2025
Date Signed: 03/25/2025 10:06:51 AM

Document Has Been Signed on 03/25/2025 10:06 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:TIMBER RIDGE AT EUREKAFACILITY NUMBER:
125000579
ADMINISTRATOR/
DIRECTOR:		FARNUM, LARONAFACILITY TYPE:
740
ADDRESS:2740 TIMBER RIDGE LANETELEPHONE:
(707) 443-3000
CITY:EUREKASTATE: CAZIP CODE:
95503
CAPACITY: 75CENSUS: 50DATE:
03/25/2025
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Larona FarnumTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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At approximately 8:15AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to complete a Required-1 Year inspection. LPA met with Administrator Larona Farnum and explained the purpose of the visit. At approximately 8:30AM, LPA conducted a review of 10 resident records. 10 of the 10 residents records contained the required documents. Evidence of recent physician reports, current appraisals and all other documents were included in the file.

At approximately 9:15AM LPA conducted review of 10 staff records. LPA observed all records contained evidence of required annual training. Evidence of current First Aid and CPR certification was present.



No citations issued during this visit.
NAME OF LICENSING PROGRAM MANAGER: Bethany Moellers
NAME OF LICENSING PROGRAM ANALYST: Christopher Arnhold
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2025
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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