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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002924
Report Date: 03/13/2025
Date Signed: 03/13/2025 04:27:28 PM

Document Has Been Signed on 03/13/2025 04:27 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:CITRUS PINES SENIOR LIVINGFACILITY NUMBER:
345002924
ADMINISTRATOR/
DIRECTOR:
KELLY, JANELYNFACILITY TYPE:
740
ADDRESS:8300 PATTON AVETELEPHONE:
(279) 529-2045
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 5DATE:
03/13/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:Janelyn Kelly, Administrator TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to a recent incident report submitted to the Department. LPA met with Janeyn Kelly, Administrator, and explained the purpose of today's inspection. Also present was Jhamil Espino, Jacob Espino, and Nikolas Martinez, caregivers. LPA observed all (5) residents to be present in their rooms.

LPA discussed the incident report when resident (R1) was sent to the emergency room on Sunday, March 9, 2025, around 8:30 am. While providing care, staff observed blood in resident's urine and a red rash to be covering most of resident's body on both sides. Additionally, resident's urine smelled foul. Resident returned the same day, around 5:00 pm with three new prescriptions to treat a urinary tract infection (UTI) and skin rash. There was no definitive diagnosis. Resident went to a follow up appointment with the primary care physician on March 13, 2025, and was told to stop taking the Keflex 500 mg. The Administrator advised family members that a written order is needed to stop any medication. The family members informed the Administrator that a referral was also made to the dermatologist and urologist.

As of today, the rash is no longer red, and the resident is not complaining of itchiness, The color of the rash also looks better, there is no blood or unusual odor. Since returning from the emergency room on Sunday evening (5:30 pm), the facility has implemented infection control protocols, including one staff providing care only to (R1) and while wearing PPE (Mask, gown and gloves). No other residents have shown or complained of any rash or itching. (R1) continues to be monitored closely for any changes in condition, including the condition of the rash. LPA spoke briefly to (R1) who indicated they are doing better and don't have any complaints.

LPA and Administrator toured the facility and the Administrator pointed out the upgrades made to the back patio area, including a walking path and more space for outdoor activities, such as live musicians.
The facility followed appropriate protocols in sending resident out and upon resident's return.

There are no deficiencies issued in this report. Exit interview. Copy of report provided.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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