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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700555
Report Date: 01/21/2025
Date Signed: 01/21/2025 04:10:27 PM

Document Has Been Signed on 01/21/2025 04:10 PM - 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:SUMMERSET LINCOLN ASSISTED LIVINGFACILITY NUMBER:
312700555
ADMINISTRATOR/
DIRECTOR:		MEGAN GALLAGHERFACILITY TYPE:
740
ADDRESS:550 2ND STTELEPHONE:
(916) 644-3151
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 162CENSUS: 94DATE:
01/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Megan GallagherTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On 01/21/25 Licensing Program Analysts (LPAs) Graham Gunby and Cheyenne Ratajczak arrived unannounced at the facility to conduct a required 1-year annual inspection. LPAs met with Executive Director (ED), Megan Gallagher, and explained the purpose of the visit.

LPAs and ED conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: (10) resident rooms, laundry room, kitchen, dining room, theater, sports lounge, mail area, medication room and common areas. LPAs observed residents in common areas participating in activities and in the dining room having lunch. The residence was found to be clean, safe, sanitary and in good condition.

LPA observed the facility to have the mandated posters posted. Fire extinguishers are maintained and ready for emergency use. Facility has required food supplies. There are appropriate staff present to meet the needs of residents.

LPA conducted a file review of ten (10) resident files and ten (10) staff files. Resident and staff files had all the required documents present in files.

No deficiencies cited. Exit interview conducted and a copy of the report was provided.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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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