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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315002995
Report Date: 10/17/2024
Date Signed: 10/17/2024 03:20:18 PM

Document Has Been Signed on 10/17/2024 03:20 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:PRESTIGE ENVIRONS FOR THE AGESFACILITY NUMBER:
315002995
ADMINISTRATOR/
DIRECTOR:		HEARD, TERESITAFACILITY TYPE:
740
ADDRESS:5350 NORTHCLIFF DRIVETELEPHONE:
(916) 625-1012
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 6CENSUS: 2DATE:
10/17/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:55 PM
MET WITH:Teresita Heard, Administrator TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual inspection. LPA met with Teresita Heard, Administrator, and explained purpose of inspection. Administrator had a question about when her annual fees were due. LPA then discovered that the annual inspection is not due until 2/28/25. There are currently (2) residents and neither resident is under hospice care.

LPA and Administrator toured the inside of the facility and observed (1) resident present. A second resident was currently out of the facility. LPA observed the facility to be clean, in good repair and odor free. LPA observed sufficient 2+ day perishable and 7+day non-perishable food on hand. The inside temperature measured 72*F, and the fire extinguisher was last serviced 4/29/24.

Administrator confirmed that all contact information on file is current. LPA observed multiple postings to be in the common area. Administrator certificate #6003786740- exp 7/7/25.

There are no deficiencies issued in today's report.

Exit interview. Copy of report emailed, as requested, to the Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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