<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577005047
Report Date: 08/25/2023
Date Signed: 08/25/2023 05:44:55 PM

Document Has Been Signed on 08/25/2023 05:44 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:BRIDGEWAY CAREFACILITY NUMBER:
577005047
ADMINISTRATOR:RAMON SILVESTREFACILITY TYPE:
740
ADDRESS:2512 MEADOWLARK CIRCLETELEPHONE:
(916) 239-8948
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY: 6CENSUS: 3DATE:
08/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Stacy Silvestre, Co Administrator and Elizabeth Miranda, Caregiver TIME COMPLETED:
05:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual Required inspection and met with Elizabeth Miranda, caregiver/assistant to the Licensee and Stacy Silvestre, Co-Administrator.

There were 2 caregivers and 3 residents at the time of inspection. All residents looked well-cared for and were very cheery to LPA. Required postings were present on hallway at entrance ot facility. There were also postings reminding residents, staff and visitors of Infection Control protocols. The facility was clean and well-organized. There was an ample supply of fresh and non-perishable foods. The carestaff were preparing dinner at the time of inspection. The bathrooms were clean and sanitary and had the required grab bars. The facility provides a land line phone for residents to stay in touch with family and friends.

There was a newly purchased Fire Extinguisher that was charged and operational, one carbon monoxide detector which was tested and operational, and 9 smoke detectors which were tested and operational.

There were no deficiencies found at the time of inspection. No citations issued.

Exit interview conducted with Stacy Silvestre, whose signature on this document confirms receipt.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1