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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001498
Report Date: 05/28/2026
Date Signed: 05/28/2026 03:24:48 PM

Document Has Been Signed on 05/28/2026 03:24 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 TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR/
DIRECTOR:		MAGDA LUISFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 49CENSUS: 48DATE:
05/28/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Rachael Robert, Resident Care Coordinator TIME VISIT/
INSPECTION COMPLETED:
03:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met Rachael Robert, Resident Care Coordinator (RCC). LPA stated the reason for the inspection was to follow up on an incident report recently submitted to the Department involving resident (R1) who eloped from the community on May 26, 2026 (10:53 am).

The RCC explained that (R1) was able to exit the facility through the front entrance without being observed by staff because the concierge staff had to cover for a care staff who had called out for work around 7:20 am after the morning shift began. At the time (R1) exited the building, the concierge staff was attending to residents at the other end of Hall #1, which is away from the front entrance. The RCC added that (R1) began pushing on the front door and then walked away from the door when the alarm was triggered; however, when the alarm stopped, (R1) walked back to the front entrance, exiting to the parking lot. The RCC stated she and staff immediately searched within the facility but were unable to locate (R1), who wasn't able to be seen on the cameras.

At 11:00 am, the RCC and a Med-Tech drove in separate cars to search for (R1) in the nearby area, but were not able to locate them. Around 11:15 am, the local police were contacted and at 12:14 pm, (R1) was returned to the community after being found in a nearby neighborhood. The incident report notes (R1) returned without any "injuries, pain, distress or change in condition."

The RCC stated that following the incident, maintenance staff checked the front door to ensure the door doesn't unlock before 15-20 seconds of the alarm sounding. The RCC indicated that staff will be instructed today (3:15 pm) on how the timing works on the egress door unlocking after the alarm sounds.
*cont on 812C-1..
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 05/28/2026
NARRATIVE
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809C-1.. The RCC stated that a Wander Guard anklet was previously placed on (R1); however, (R1) would regularly tear it off, and staff would find it in (R1's) room in the trash can. Before (R1) exited from the community, staff ensured that (R1) was wearing the anklet earlier that morning, but it was found in the trash can when searching for (R1).

LPA and RCC spoke with (R1) during today's inspection in their room. LPA observed (R1) to be wearing a necklace with a monitoring device. (R1) admitted to throwing away anklets that were previously placed on them. LPA stated to (R1) that for their safety, they need to have a buddy with them when leaving the facility. (R1) appeared to understand. The RCC stated that (R1) left the facility due to wanting to walk, and staff will continue to take (R1) on walks.

The incident report notes that updates were made to (R1's) Elopement Risk Evaluation, Assessment and Service Plan following the incident. Additionally, the report notes staff will be retrained on elopement response as well as door safety and monitoring procedures. Additionally, the RCC stated (R1's) primary care physician is looking into possibly modifying medications (R1) is currently taking. The RCC stated she will look into offering a different kind of monitoring device, if needed, that is compatible with the current Wander Guard system.

Per California Code of Regulations, Title 22, Division 8, Chapter 6, the following (1) deficiency is being cited related to resident (R1), on the 809-D page. There is a civil penalty also being issued due to a repeat violation.

Exit interview. Copy of report and appeal rights provided.
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/28/2026 03:24 PM - It Cannot Be Edited


Created By: Sabrina Calzada On 05/28/2026 at 02:54 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/29/2026
Section Cited
CCR
87705(f)(6)

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87705 Care of Persons with Dementia
(f) Licensees that lock exterior doors or perimeter fence gates shall meet the following initial and continuing requirements: (6) Locked exterior doors or perimeter fences with locked gates shall not substitute for trained staff in sufficient numbers to meet the care and supervision needs of all residents. This requirement is not met as evidenced by:
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Licensee/Administrator agree to conduct training on the timing of the egress door, specific to when the alarm sounds and when the door unlocks. The Administrator will hold an elopement drill today (pm shift) to note which caregivers attended to the alarms with urgency and who did not, and note the reason they did not and follow up with disciplinary action.
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Based on documentation reviewed and an interview conducted, the Licensee did not ensure that resident (R1) was unable to exit the facility, unassisted, on May 26, 2026 (10:53 am), which posed an immediate health and safety risk to residents in care. (R1) was returned to the facility around 12:14 pm, with no injuries noted.
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(R1's) care plan was updated with more details of care needed to address the elopement risk. The facilitly will consider obtaining another type of bracelet/anklet that (R1) cannot remove easily. The facility will continue to communicate (R1's) primary care physician. Documentation of training due to CCLD by tomorrow, 5/29/26 (COB).

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lauren Crocker
NAME OF LICENSING PROGRAM MANAGER:
Sabrina Calzada
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/28/2026


LIC809 (FAS) - (06/04)
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