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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700801
Report Date: 11/14/2024
Date Signed: 11/14/2024 02:56:19 PM

Document Has Been Signed on 11/14/2024 02:56 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:MINNESOTA HOME CAREFACILITY NUMBER:
342700801
ADMINISTRATOR/
DIRECTOR:		OKYERE, VERA A.FACILITY TYPE:
740
ADDRESS:7448 MINNESOTA DR.TELEPHONE:
(916) 729-9461
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 2DATE:
11/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Vera Okyere, Administrator TIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required quarterly case management inspection. LPA met with Vera Okyere, Administrator, and explained purpose of inspection. Also present was Lydia Awuku, caregiver.

LPA observed (0) residents in the common area and (3) residents to be in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (4). Currently, there are (2) residents present, (1) resident in the hospital and (0) residents on hospice.

LPA reviewed the binder with documentation of monthly training for all (3) staff to have been completed for April thru October, 2024. Training topics varied each month: Dementia care, postural supports, Aging Process, Importance of Personal Care, Psychosocial Needs of the Elderly, and Nutrition and Exercise.

LPA and Administrator toured the inside areas of the facility including kitchen, bathroom, resident rooms, laundry area and staff rooms. LPA observed all areas to be clean and in good repair.

LPA advised the Department will conduct a subsequent quarterly visit on/around February 2025.

There are no deficiencies cited in this report. Exit interview. Copy of report provided to Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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