<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 312700371
Report Date: 02/22/2024
Date Signed: 02/22/2024 04:12:05 PM


Document Has Been Signed on 02/22/2024 04:12 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:WESTWOOD TERRACE CARE HOMEFACILITY NUMBER:
312700371
ADMINISTRATOR:FILIMON, LARISAFACILITY TYPE:
740
ADDRESS:618 LUCY LNTELEPHONE:
(916) 771-2227
CITY:ROSEVILLESTATE: CAZIP CODE:
95678
CAPACITY:6CENSUS: 5DATE:
02/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:05 PM
MET WITH:TIME COMPLETED:
04:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Kevin Mknelly arrived on Tuesday 2/24/24 to conduct the annual inspection.

During today's annual inspection, the CARE Tool was used. LPA reviewed resident (5) and staff files (3). All resident files contained the required paperwork. All staff files contained the required paperwork and training. All staff have current first aid and CPR training. First aid kit was fully stocked. Facility was clean and well organized. Facility is current on fire drills. All required posting were observed.

LPA and Administrator Larisa toured the facility together to ensure the health and safety of residents in care. The areas toured included resident rooms, bathrooms, kitchen, and common areas. Water temperatures in kitchen and bathrooms were within the required range of temperatures. In the areas toured, there were no health or safety violations observed.

LPA obtained confirmation of liability insurance.

No deficiencies cited. Exit interview conducted. A copy of this report was emailed to the Administrator. .
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2