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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002952
Report Date: 11/14/2024
Date Signed: 11/14/2024 02:01:16 PM

Document Has Been Signed on 11/14/2024 02:01 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:SHARON'S CARE HOMEFACILITY NUMBER:
455002952
ADMINISTRATOR/
DIRECTOR:		BERRY, CASSIEFACILITY TYPE:
740
ADDRESS:3544 LAKE FOREST DRIVETELEPHONE:
(530) 953-7292
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY: 6CENSUS: 5DATE:
11/14/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Administrator, Cassie BerryTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On November 14, 2024 at approximately 12:00 PM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Sharon's Home for the purpose of conducting a Required 1 year inspection. LPA was greeted at the door by Caregiver, Christopher Bell and was granted access into the facility.

LPA and the Administrator toured the facility. LPA observed the facility was found to be clean and at a comfortable temperature with all exits free from obstruction. However, LPA was informed that the fence is currently in the process of being replaced. LPA observed the fence being in moderate condition with one fence plank having a crack on it caused by the next door neighbors dogs. LPA advised to let CCL know when the fence will be completed (See LIC 9102-Technical Assistance). Fire Extinguishers were found to be last charged on July 2024 at the time of the inspection. All smoke detectors and carbon monoxide detectors were tested and found to be operational at the time of the inspection. Water temperature in residents bathrooms measured at 108 degrees in 2 of 2 residents bathrooms and is within acceptable range of 105 to 120 degrees F. LPA observed sufficient perishable and non-perishable foods located in the kitchen. There are special provisions made for individuals with special dietary needs. Food menu was presently available for viewing during the inspection. Medications were centrally stored and locked. Medication orders for residents in care were reviewed and found to be appropriate during the inspection. First Aid Kit was inspected and found to be appropriate during the inspection. Cleaning products and other toxins are located in the laundry room that was locked and inaccessible to residents in care. There was a supply of linens, cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents in the common areas at the facility were supplied with individual paper towels and hand soap. Bathrooms in resident’s rooms have a towel and soap. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A tour of all residents bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishings. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms of COVID-19 or other infectious diseases are present in the facility. (Report continued on LIC 809C)
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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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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: SHARON'S CARE HOME
FACILITY NUMBER: 455002952
VISIT DATE: 11/14/2024
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LPA requested the following documents to be sent:

LIC 500- Personnel Report
LIC 308- Designation of Facility Responsibility
LIC 309- Administrative Organization
Most up-to-date Liability insurance
Control of Property
Register of residents

No deficiencies were observed or cited during today's Required 1 year inspection. Exit interview was conducted and a copy of this report was signed and given to the Administrator.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
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