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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045002168
Report Date: 09/12/2024
Date Signed: 09/12/2024 11:44:07 AM

Document Has Been Signed on 09/12/2024 11:44 AM - 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:FERRER HOME CARE NO. 3FACILITY NUMBER:
045002168
ADMINISTRATOR/
DIRECTOR:		MABEL, MAXINEFACILITY TYPE:
735
ADDRESS:86 ARTESIA DRIVETELEPHONE:
(530) 342-9779
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY: 6CENSUS: 3DATE:
09/12/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:25 AM
MET WITH:Administrator- Maxine Mabel TIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 09/12/2024, Licensing Program Analyst (LPA) Jaynae Boyles, arrived at the facility unannounced to conduct a 1-Year Required Annual Inspection. LPA met with Facility Administrator, Maxine Mabel and explained the purpose of the visit.

LPA Boyles and Administrator toured facility together to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, backyard, shed, and common restrooms.

LPA observed each bathroom to have the necessary grab bars, non-skid flooring or shower chair, paper towels, trash can with lids and 20-second hand-washing poster. Facility has a 2-day perishable and a 7-day non-perishable amount of food. LPA observed the menu to be posted for the residents. LPA observed an activities room filled with supplies. LPA observed resident bedrooms to have all the required furnishings, windows with screens and working lights/fan. LPA observed chemicals, knives and medications to be locked inaccessible to residents.

Hot water temperature was measured at 105 F. LPA observed two (2) fire extinguishers, fire detectors, and carbon monoxide detectors throughout the facility. LPA observed a completed first aid kit ready for emergency use. LPA observed an emergency disaster plan and drills conducted as required.

In the areas toured no immediate health, safety, or personal rights violations were observed. LPA observed the facility to be clean, in good repair and odor-free.

LPA reviewed a total of three (3) residents' files and five (5) staff files which contained all the required documentation.

Several topics were discussed.

No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report left at the facility.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Jaynae Boyles
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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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