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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 310300209
Report Date: 02/18/2025
Date Signed: 02/18/2025 03:47:39 PM

Document Has Been Signed on 02/18/2025 03:47 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:ERICKSON'S FAMILY CARE HOMEFACILITY NUMBER:
310300209
ADMINISTRATOR/
DIRECTOR:		MAXWELL, LINDAFACILITY TYPE:
735
ADDRESS:356 WEST WISE ROADTELEPHONE:
(916) 955-5198
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 6CENSUS: 3DATE:
02/18/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Licensee Linda MaxwellTIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Graham Gunby arrived on Tuesday February 18, 2025 to conduct the unannounced annual inspection. LPA met with Licensee Linda Maxwell and explained the purpose of today's visit.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA Gunby reviewed client (3) and staff (2) files. All client files contained the required paperwork. All staff files contained the required paperwork and training.

LPA Gunby and Licensee Linda toured the facility together to ensure the health and safety of clients in care. The areas toured included bedrooms, office, kitchen, bathrooms, front yard and common areas. All chemicals and toxins were kept locked and inaccessible to clients. Facility has (3) fire extinguishers (kitchen, office, back of house). In the areas toured, there were no health or safety violations observed.

No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the Licensee.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2025
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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