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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920040
Report Date: 02/20/2025
Date Signed: 04/07/2025 01:31:23 PM

Document Has Been Signed on 04/07/2025 01:31 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:SIERRA RIDGE SENIOR LIVINGFACILITY NUMBER:
315920040
ADMINISTRATOR/
DIRECTOR:
JENNIFER FUSTONFACILITY TYPE:
740
ADDRESS:3265 BLUE OAKS DRIVETELEPHONE:
(530) 718-1553
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY: 65CENSUS: 42DATE:
02/20/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Alexis ThackerTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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On 2/20/2025 LPA Tryon visited the facility to do an annual review LPA met with Executive Director Alexis Thacker.
LPA toured the facility with Ms. Thacker including common areas, resident rooms, bathrooms, dining room, kitchen, hallways, storage areas, med room, offices, break room, and outside area. The facility was recently renovated/redecorated last year. The facility is clean, bright, newly furnished and pleasant. Furnishings are all in good condition. Bedroom furnishings are appropriate. Food supplies are plentiful, appear fresh and varied. Supply appears to meet the requirement of 2 days perishable and 7 days non-perishable. Food is stored appropriately and cooler/freezer at appropriate temperature per regulation. The facility has plenty of dishes, pots/pan/cookware. The kitchen appeared very clean and orderly,
Plumbing and fixtures appear to be functional and in good condition.
Temperature in the facility was comfortable, water temp within appropriate range as per regulations.

LPA reviewed 6 resident files and 5 staff files. Files included required information.

LPA was not able to interview residents due to disability.

LPA spoke with one staff member.

LPA reviewed the CARE Tool with Ms. Thacker.

At this time, the facility appears to be in substantial compliance with the regulations. No deficiencies were cited.

Exit interview conducted, copy of report given to Executive Director.
NAME OF LICENSING PROGRAM MANAGER: Troy Ordonez
NAME OF LICENSING PROGRAM ANALYST: Todd Tryon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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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