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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920129
Report Date: 05/31/2024
Date Signed: 05/31/2024 03:53:18 PM

Document Has Been Signed on 05/31/2024 03:53 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:GOLDEN HEART CARE HOME LLCFACILITY NUMBER:
315920129
ADMINISTRATOR/
DIRECTOR:		BOWEN, ROWENA MARY BAUTISTFACILITY TYPE:
740
ADDRESS:780 RED BUD LNTELEPHONE:
(530) 717-5178
CITY:MEADOW VISTASTATE: CAZIP CODE:
95722
CAPACITY: 3CENSUS: 0DATE:
05/31/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Rowena BowenTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 5/31/2024 LPA Tryon made a quick visit to the facility to view modifications made to the back deck as per pre-licensing visit. LPA had noted that there is a stairway directly outside the back sliding door from the dining room. The deck is only a few feet wide, and could be an area of potential fall risk. The stairs lead down to a fenced in area at the bottom with no outlet.

The applicant has closed off the opening for the stairs at that location. However, there are 2 alternate exits from the patio. One leads down stairs side of the house; the other goes down a deck pathway that leads around the house to the front patio, then down. Both are protected by small gates that can be opened from either side.

At this time, the facility appears to be in substantial compliance with regulations.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 05/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/31/2024
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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