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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701286
Report Date: 01/15/2025
Date Signed: 01/15/2025 01:54:40 PM

Document Has Been Signed on 01/15/2025 01:54 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:
01/15/2025
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Beatrice ClarkTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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A virtual informal conference -  office meeting was held via Microsoft Teams to discuss Beatrice Home Care. Present in today's meeting was Licensing Program Analyst (LPA) Christina Valerio, Licensing Program Manager (LPM) Stephen Richardson, and Facility Representative, Licensee Beatrice Clark.

The following topics were discussed during the informal conference:
  • Personnel Requirements
  • Care of Persons with Dementia
  • Building and Grounds
  • Maintenance and Operation
    Personal Rights of Residents in All Facilities
  • Staff training
  • Activities

The facility will do the following to achieve compliance:
  • Continue to maintain cleanliness of facility
  • Continue to maintain upkeep of building and grounds
  • Update monthly calendar for activities offered and completed
  • Continue to train staff and document in-service training
  • Continue to monitor and document water temperatures



Continues LIC 809 - C...
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/15/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: BEATRICE HOME CARE
FACILITY NUMBER: 342701286
VISIT DATE: 01/15/2025
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Continued from LIC 809

The facility will do the following to achieve compliance:
  • Continue to ensure cleaning supplies are locked an inaccessible to residents in care
  • Continue to ensure staff are fingerprinted and associated to the facility prior to providing direct care
  • Continue to maintain resident and staff files and have it readily available at the facility
  • Continue to collaborate and update Regional Office as needed

The regional office will do the following:
  • Continue to collaborate and provide assistance to licensee as needed

LPM Richardson discussed the option for the Technical Support Program (TSP) and informed licensee to inform the Regional office if they would be interested in participating. At this time, the licensee did not want to participate, LPA Valerio sent a copy of the TSP handout should the licensee change her mind.

Per California Code of Regulations (CCR) - Title 22 - no deficiencies are being cited. An exit interview was held, and a copy of the report was sent via email.


Licensee to send a signed copy to LPA Valerio.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC809 (FAS) - (06/04)
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