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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700042
Report Date: 02/13/2025
Date Signed: 02/13/2025 03:11:28 PM

Document Has Been Signed on 02/13/2025 03:11 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:SUMMERSET LINCOLN ASSISTED LIVING AND MEMORY CAREFACILITY NUMBER:
312700042
ADMINISTRATOR/
DIRECTOR:
MEGAN GALLAGHERFACILITY TYPE:
740
ADDRESS:567 3RD STREETTELEPHONE:
(916) 409-4150
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY: 132TOTAL ENROLLED CHILDREN: 0CENSUS: 58DATE:
02/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Executive Director Megan GallagherTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Graham Gunby arrived on Thursday February 13, 2025 to conduct the unannounced annual inspection.

During today's annual inspection, the Compliance and Regulatory Enforcement Tool was used. LPA reviewed resident (10) and staff (10) files. All resident files contained the required paperwork. All staff files contained the required paperwork and training.

LPA and Administrator toured the facility together to ensure the health and safety of residents in care. The areas toured included common areas, medication rooms, kitchen, and dining rooms. LPA observed the facility's emergency food, water storage and PPE. All water temperatures were within the required range. First aid kit is fully stocked. In the areas toured, there were no health or safety violations observed.

LPA received a copy of the facility's liability insurance.

No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the Executive Director.
Troy OrdonezTELEPHONE: (916) 263-4832
Graham GunbyTELEPHONE: (916) 827-6870
DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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