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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920030
Report Date: 12/18/2024
Date Signed: 12/18/2024 02:59:56 PM

Document Has Been Signed on 12/18/2024 02:59 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:DIAMOND OAKS HOME CAREFACILITY NUMBER:
315920030
ADMINISTRATOR/
DIRECTOR:		GARCIA, RICHARDFACILITY TYPE:
740
ADDRESS:403 MURRAY CT.TELEPHONE:
(916) 770-4233
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 6CENSUS: 3DATE:
12/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Richard GarciaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 12/18/24, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit while delivering complaint findings and met with Administrator, Richard Garcia .

On 11/20/24, licensee submitted a incident report regarding R1. R1 had developed diarrhea while on hospice. Staff coordinated with hospice to manage symptoms. On 11/18/ 24 R1 was sent to the hospital due to decline. In the hospital, R1 did not respond to medical treatments and died on 11/30/24.

LPA's records review and interview found that staff coordinated with hospice services and sought appropriate medical attention timely.

As a result of today’s inspection, no deficiencies were noted.

Report reviewed. Copy of report and appeal rights provided
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/18/2024
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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