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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 317005513
Report Date: 03/18/2025
Date Signed: 03/18/2025 10:57:04 AM

Document Has Been Signed on 03/18/2025 10:57 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:VISTA ROSEVILLE SENIOR LIVINGFACILITY NUMBER:
317005513
ADMINISTRATOR/
DIRECTOR:		KIMBRO, SHERIFACILITY TYPE:
740
ADDRESS:100 STERLING CTTELEPHONE:
(916) 786-7200
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY: 128TOTAL ENROLLED CHILDREN: 0CENSUS: 71DATE:
03/18/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Administrator, Sheri KimbroTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Talwinder Bains arrived at the facility unannounced on 03/18/25 to do case management visit. LPA met with administrator, Sheri Kimbro and explained the purpose of the visit.

Department followed up on an Incident Report (IR) sent by the facility on 02/25/25. On 02/25/25, around 1400, R1 and R2 had an altercation in the memory care unit where R1 was physically aggressive towards R2 by pulling their hair and not letting go. Care staff was present at that time and tried to de-escalate the situation. Staff separated R1 and R2 immediately and checked both residents for any injuries, but none were found.


Department conducted interviews with residents and staff regarding this incident during today’s visit.

LPA determined from record review, staff, and resident interviews that facility took appropriate measures to address this incident and reported this incident to all relevant parties as required.

No citations were issued per Title 22 Regulations.
Exit interview conducted and copy of the report left at facility.
Laura MunozTELEPHONE: (916) 263-4743
Talwinder BainsTELEPHONE: (916) 263-4700
DATE: 03/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2025
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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