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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920051
Report Date: 09/18/2024
Date Signed: 09/18/2024 03:47:58 PM

Document Has Been Signed on 09/18/2024 03:47 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:SONRISA SENIOR LIVINGFACILITY NUMBER:
315920051
ADMINISTRATOR/
DIRECTOR:		PICKARD, CAROLFACILITY TYPE:
740
ADDRESS:1031 ROSEVILLE PKWYTELEPHONE:
(279) 213-0047
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY: 199CENSUS: 114DATE:
09/18/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Carol PickardTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analysts (LPA) Graham Gunby and Kevin Mknelly arrived unannounced at the facility to conduct a required annual inspection utilizing the full CARE tool. LPA met with Executive Director, Carol Pickard, and explained the purpose of the visit.

Today's census is 114 residents, the facility is licensed for 199 residents with a hospice waiver for 15.

During today's inspection, LPAs and Executive Director conducted a tour the interior and exterior of the facility. Areas toured included but not limited to: courtyard, memory care unit bedrooms, assisted living unit bedrooms, main dining, kitchen, gym, and the common areas. LPAs observed care staff assisting residents with walking and other activities. LPAs observed the facility to be clean, safe and in good repair.

File review was conducted for 10 residents and 6 personnel files. LPAs observed the files to be mostly complete with the required documents. Inspection tool completed and found facility to be in substantial compliance. LPAs noted and discussed with the administrator the requirements for the hospice care plan content. During the personnel file reviews LPAs requested copies of 2 staff first aid training certificates.


No deficiencies observed during today's inspection. Exit interview conducted and a copy of report was provided.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/18/2024
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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