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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045000789
Report Date: 03/21/2024
Date Signed: 03/21/2024 01:26:28 PM

Document Has Been Signed on 03/21/2024 01:26 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:HIGHLAND VIEW CARE HOMEFACILITY NUMBER:
045000789
ADMINISTRATOR:SERRANO,NORA CHAVEZFACILITY TYPE:
735
ADDRESS:62 HIGHLANDS BLVD.TELEPHONE:
(530) 533-3079
CITY:OROVILLESTATE: CAZIP CODE:
95966
CAPACITY: 6CENSUS: 3DATE:
03/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Nora Serrano Licensee / administratorTIME COMPLETED:
01:30 PM
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03/21/2024 11:30 AM Licensing Program Analysts (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with administrator Brian Moebs ( 6040491735 exp. 06/01/2024 ) and Virginia Moebs and explained the purpose of the visit. Licensee Nora Chavez-Serrano was unavailable for the visit due to a pre-scheduled appointment.

LPA and the administrator toured the facility together to ensure the health and safety of clients in care. Areas toured include but are not limited to three (3) resident rooms, common areas, two (2) bathrooms, kitchen, storage areas, laundry and yard. Staff and client files were reviewed. Medications were also reviewed.

Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food. Medication is locked in a cabinet.

Fire extinguishers fully charged and were inspected in March 2024. Smoke detectors are all operational. All employees requiring background checks are cleared. All required postings are displayed within facility.

No pools/bodies of water are on premises. Last disaster drill was conducted on October 4, 2023 which was a fire drill the facility has been conducting drills every 6 months, facility will add fire drills every three months.

In the areas toured no immediate health, safety, or personal rights violations were observed. No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was provided to licensee Nora Chavez-Serrano

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
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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