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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 315920196
Report Date: 03/19/2025
Date Signed: 03/20/2025 09:39:27 AM

Document Has Been Signed on 03/20/2025 09:39 AM - 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:AUBURN RAVINE TERRACE ASSISTED LIVINGFACILITY NUMBER:
315920196
ADMINISTRATOR/
DIRECTOR:
JONES, JAMIEFACILITY TYPE:
740
ADDRESS:750 AUBURN RAVINE ROADTELEPHONE:
(530) 823-6131
CITY:AUBURNSTATE: CAZIP CODE:
95603
CAPACITY: 25CENSUS: 16DATE:
03/19/2025
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Jamie Jones, Administrator and Kristie FainTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 3/19/2025 LPA Tryon visited the facility to conduct a Pre-licensing inspection. LPA met with Administrator Jamie Jones and Kristie Fain, Assisted Living Supervisor. The facility has been licensed ongoing for many years and there are 16 residents living here. This visit is for a pre-licensing for a CHANGE OF OWNERSHIP with residentsvin care.

LPA toured the facility including common areas, dining room, kitchen area in Assisted Living, the main facility kitchen upstairs; resident apartments, bathrooms, hallways, laundry, storage, offices. The facility has Independent Living on the other floors of the buildings, main kitchen is upstairs on a separate floor.

Food supplies were adequate to meet the requirement of 2 days perishable and 7 days non-perishable. Food appears varied and appetizing. Kitchen was clean and well-furnished. Food is cooked in the mail kitchen upstairs and taken down to Assisted Living in closed carts, served to residents; and then items are sent back to the kitchen after meals. Dishes are kept in AL and washed there.
Each apartment has a kitchen area, living room, bedroom and bathroom. Apartments are clean and nicely set up and furnished, include appropriate bedroom furniture, linens, towels, etc.

Facility has a central fire alarm/detection system. Rooms have combined smoke detector/carbon monoxide detector units. Fire extinguishers are present and charged.

At this time, the facility appears to be in substantial compliance with regulations.

LPA is waiving the requirement for RCFE Orientation Component III at this time, as Administrator has been working as an Administrator for some time now.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Todd Tryon
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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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