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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 097005326
Report Date: 03/10/2025
Date Signed: 03/10/2025 01:56:17 PM

Document Has Been Signed on 03/10/2025 01:56 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:SENIOR DAY CARE CENTER- EL DORADO HILLSFACILITY NUMBER:
097005326
ADMINISTRATOR/
DIRECTOR:
JILLIEN SMITHFACILITY TYPE:
775
ADDRESS:990 LASSEN LANETELEPHONE:
(916) 358-3560
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY: 30CENSUS: 8DATE:
03/10/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Program Manager Yvette WenckeTIME VISIT/
INSPECTION COMPLETED:
02:10 PM
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Licensing Program Analyst (LPA) Lavinia Muscan arrived on March 10, 2025 to conduct the annual inspection.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed client (4) and staff files (2). All client files contained the required paperwork. All staff files contained the required paperwork. All staff have current first aid and CPR training. Facility was clean and well organized. Facility is current on fire drills. All required posting were observed.

LPA and Program Manager Yvette Wencke toured the facility together to ensure the health and safety of residents in care. The areas toured included client class rooms, bathrooms, kitchen, and common areas and outside area. All exits were unobstructed. The disaster drill is current. There is a side gate for emergency access. LPA checked the kitchen area for the ability to prepare and store food. Knives and Sharp objects found to be locked . LPA observed cleaning products and other toxins to be locked away. LPA observed the area used for medication to be locked and inaccessible to clients. LPA observed smoke detectors and carbon monoxide detector at the are operational. Fire extinguisher is ready for emergency use. Water temperature is within compliance. In the areas toured, there were no health or safety violations observed.

LPA requested a copy of the LIC 500 and LIC610E to be sent to the Department by end of the month.

Exit interview conducted. A copy of this report was printed and given to Program Manager.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Lavinia Muscan
LICENSING EVALUATOR SIGNATURE: DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/10/2025
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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