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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 126801366
Report Date: 06/16/2021
Date Signed: 06/16/2021 11:45:19 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:TIMBER RIDGE AT MCKINLEYVILLEFACILITY NUMBER:
126801366
ADMINISTRATOR:FARNUM, LARONAFACILITY TYPE:
740
ADDRESS:1400 NURSERY WAYTELEPHONE:
(707) 839-9100
CITY:MCKINLEYVILLESTATE: CAZIP CODE:
95519
CAPACITY:108CENSUS: 64DATE:
06/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Barbara BeckTIME COMPLETED:
12:00 PM
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At approximately 8:45 AM, Licensing Program Analyst (LPAs) Shannan Hansen & Chris Arnhold arrived at this facility, unannounced, to conduct an Annual Required inspection. This inspection will focus on the Infection Control procedures and practices of this facility. LPAs met Director of Care Services, Barbara Beck. There were 64 residents present at the facility.
LPAs arrived at the facility and had temperature checked and health questions asked. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Resident bedrooms, common areas, kitchen & food storage areas were inspected. Fire Extinguishers were found to be charged and inspected within the last 12 months. Smoke Detectors & Carbon monoxide detector was found to be operational during the visit. Food stores of perishable and nonperishable foods were within regulation. Food in the kitchen refrigerator was properly stored. Toxins are stored and not accessible. There was a supply of cleaners, hygiene products and paper products available for resident use.
Facility has submitted and received approval for a Covid Mitigation plan. Posters are in place at the entrance and throughout the building. The entrance area has a small table with hand sanitizer. Staff brought out thermometer and other items designated for visitors and staff before coming into work. Facility has PPE supplies. Medications are secure and not accessible to residents. Facility has a 30-day supply of medication for residents. Residents do not typically wear masks inside the facility but have them available. Residents do however, wear masks while away from the facility.

There were no deficiencies found in the areas inspected.


No citations issued.
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Shannan HansenTELEPHONE: 707-588-1410
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
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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