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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317005413
Report Date: 06/08/2023
Date Signed: 06/08/2023 04:16:58 PM


Document Has Been Signed on 06/08/2023 04:16 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833



FACILITY NAME:ASPEN MEADOWSFACILITY NUMBER:
317005413
ADMINISTRATOR:GRACE HAWKINSFACILITY TYPE:
740
ADDRESS:531 ASPEN MEADOWS WAYTELEPHONE:
(916) 409-5620
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:6CENSUS: 3DATE:
06/08/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Ron Ordona, ApplicantTIME COMPLETED:
04:30 PM
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On Thursday June 8, 2023, an office meeting was held to discuss a change of ownership for this facility. Present in the meeting was Alycia Berryman, Regional Manager, Maribeth Senty, Licensing Program Manager, Konnor Leitzell, AGPA, Melissa Parks, Licensing Program Analyst, Ron Ordona, Applicant, and Grace Hawkins, Administrator.

The Department, Ron and Grace discussed the following topics:
  • change of ownership application
  • timeline of Albert Wilson and his exit from the ownership of the facility
  • staffing and roles at the facilities
  • prohibitive health conditions and higher level of care


The Department agreed to refer the facility to its Technical Support Program. The Department is requesting an updated LIC500 and LIC309 for both Lincoln facilities which specify Administrator time at the facilities. Ron and Grace agreed to provide training for all staff regarding prohibitive health conditions, wounds, skin integrity, incontinence care, monitoring of residents, and Dementia care by Friday June 30, 2023. Operations Manager Yas will follow-up with his Administrator certification.

Exit interview conducted. A copy of this report was provided to the Administrator.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Melissa ParksTELEPHONE: (559) 580-5423
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2023
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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