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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317005468
Report Date: 07/20/2022
Date Signed: 07/20/2022 11:46:12 AM


Document Has Been Signed on 07/20/2022 11:46 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926



FACILITY NAME:BROOKDALE AUBURNFACILITY NUMBER:
317005468
ADMINISTRATOR:MORGAN WHINERYFACILITY TYPE:
740
ADDRESS:11550 EDUCATION STTELEPHONE:
(530) 888-8847
CITY:AUBURNSTATE: CAZIP CODE:
95602
CAPACITY:110CENSUS: 69DATE:
07/20/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Morgan WhineryTIME COMPLETED:
12:30 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
On 7/20/22 LPA Tryon arrived at the facility unannounced to conduct an annual visit using the Infection Control Domain of the CARES Tool. LPA had pre-screened for COVID symptoms prior to the visit.

LPA met with Executive Director Morgan Whinery and Health and Wellness Director Yuriy Kutsenko.

LPA reviewed the Infection Control Domain of the CARES Tool with staff.

LPA toured the facility including common areas, dining room, kitchen, hallways, resident rooms, bathrooms, break room, storage, etc.

The facility has a good supply of food of various types and good quality. There are plenty of PPE supplies on the premises, COVID tests, etc.

The facility appears to be clean, well-furnished and in good condition. Residents participate in various activities and outings.

At this time, the facility appears to be in overall compliance. No deficiencies were cited at this visit.

Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 208-7709
LICENSING EVALUATOR SIGNATURE:
DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/20/2022
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 1