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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701286
Report Date: 11/05/2024
Date Signed: 11/05/2024 04:15:14 PM

Document Has Been Signed on 11/05/2024 04:15 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:BEATRICE HOME CAREFACILITY NUMBER:
342701286
ADMINISTRATOR/
DIRECTOR:
CLARK, BEATRICEFACILITY TYPE:
740
ADDRESS:1014 FERNANDO WYTELEPHONE:
(916) 270-3961
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY: 6CENSUS: 6DATE:
11/05/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Beatrice Clark TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to conduct a case management visit to clear Plan of Corrections from visit 10/24/24 . LPA Valerio met with facility staff Etta, and explained the purpose of the visit. LPA Valerio was later met by Administrator Beatrice.

On 10/24/24, the facility was cited for 87705(f), 87303(e )(2), and 87705(I)(6). LPA Valerio received staff training for 87705(f) and training for 87705(I)(6). On 11/01/2024,  Administrator Beatrice provided hot water readings for 10/25 - 11/01, which read between 105.0 - 120.0 degrees F.

On 11/05/24, LPA Valerio measured the hot water temperature in two bathrooms. Bathroom 1 measured at 105.4 degrees F. Bathroom 2 measured at 106.9 degrees F.

Based on records review and observations, the plan of corrections (POC) have been cleared. A POC letter was provided to Administrator Beatrice.

No deficiencies were cited. An exit interview was held, and a copy of the report was provided.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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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