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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920230
Report Date: 01/02/2025
Date Signed: 01/02/2025 12:55:14 PM

Document Has Been Signed on 01/02/2025 12:55 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 HEIGHTS SENIOR LIVINGFACILITY NUMBER:
345920230
ADMINISTRATOR/
DIRECTOR:
SAHOTA, SUKHMANFACILITY TYPE:
740
ADDRESS:8440 EDGECLIFF COURTTELEPHONE:
(916) 716-5999
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 5DATE:
01/02/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Sukhman Sahota, Administrator TIME VISIT/
INSPECTION COMPLETED:
12:55 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived announced to conduct a scheduled pre-licensing inspection for a change in ownership. LPA met with Sukhman Sahota, Administrator. Also present was Sherry Cort, staff, who was preparing food in the kitchen. There is a pending license for (6) non-ambulatory residents, (1) of whom may be bedridden. There are currently (5) residents who reside at the facility, and (1) resident is under hospice care. (4) residents were present during the inspection.

LPA and Administrator toured the interior and exterior of the facility, including common area, resident bedrooms, (3) resident bathrooms, kitchen, laundry and garage. LPA observed the facility to be clean, in good repair and to have sufficient furniture and lighting throughout. The bathrooms have the necessary grab bars, non-skid flooring, soap, and paper towels. Hand-washing posters (20+ seconds) to be posted near each sink. There are locked sharps, toxins and medications in the kitchen. There is sufficient 2+day perishable and 7+day non-perishable supply of food. Hot water measured 115*F in a resident bathroom and the inside temperature measured 73*F. Fire extinguisher was last serviced on 10/7/24, and the smoke/monoxide alarms are in working order. All exit doors have alarms. There are sufficient PPE/paper supplies and linens/towels/blankets as well as flashlights and night lighting. There are multiple required postings posted near the front entrance, including the Emergency Disaster Plan and Theft & Loss Policy. There are games/activities and an operating land line. There is a covered patio with table and chairs and (2) unlocked exit gates. There is a complete First Aid kit and a menu and activity calendar is posted in the kitchen. LPA reviewed (1) resident file and one large staff binder for personnel records. Files were organized and contained current information. The facility has an active subscription with an approved on-line vendor for staff training. The current land line phone number was obtained. Discussed obtaining Guardian access to manage staff rosters. LPA provided an informational page on Updates to Dementia Care and Miscellaneous Changes effective 1/1/25, and the website/email addresses for CCLD and LTCO to include in the Admission Agreement. Component III was reviewed during today’s inspection. Pre-Licensing is complete and this facility has no deficiencies.
Exit interview. Copy of report left at facility. LPA to notify to the Centralized Applications Bureau.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 01/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/02/2025
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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