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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340310966
Report Date: 02/06/2024
Date Signed: 02/06/2024 01:53:44 PM


Document Has Been Signed on 02/06/2024 01:53 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:TAYLOR HOMEFACILITY NUMBER:
340310966
ADMINISTRATOR:TAYLOR, FILOMENAFACILITY TYPE:
740
ADDRESS:3832 MILTON WAYTELEPHONE:
(916) 332-1946
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:6CENSUS: 5DATE:
02/06/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Administrator, Filomena TaylorTIME COMPLETED:
02:00 PM
NARRATIVE
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On 02/06/24 at 01:30PM, an informal conference was conducted at the Sacramento Regional office. The purpose of this informal conference meeting is to discuss the complaint citations regarding association of an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that pose immediate a risk to the health and safety of the client(s) in care. Present in the meeting is, Licensing Program Manager (LPM) Laura Munoz, Licensing Program Analyst (LPA) Talwinder Bains, and facility’s licensee/administrator, Filomena Taylor.

The informal conference process was explained during this meeting.

Issues discussed during the meeting were:
- Association of an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required
- Incidents Reporting
- Administrator’s qualifications and duties

The facility has stated they will do the following to achieve continued and substantial compliance:
• Adhere to Community Care Licensing Division (CCLD) Regulations per Title 22 for facility’s operations
• Maintain an internal audit for reporting of incidents.
• Reach out to Community Care Licensing Division (CCLD) as a resource.

During today's meeting, deficiencies are cited pursuant to California Code of Regulations,
Title 22 and documented on the attached LIC809D.

Exit interview conducted and appeal rights provided. Informal meeting concluded and a copy of report was given.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder BainsTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2024
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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Document Has Been Signed on 02/06/2024 01:53 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: TAYLOR HOME
FACILITY NUMBER: 340310966

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2024
Section Cited
CCR
87405(d)(2)

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87405- Administrator - Qualifications and Duties(d)(2)- Knowledge of and ability to conform to the applicable laws, rules and regulations….. This requirement is not met as evidenced by;
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Administrator agreed to submit a self-certification of understanding the regulation ,87405 (d)(2) and will make sure to report any reportable incidents to CCLD as required and submit proof to CCLD by POC date-02/07/24.
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Based on the records reviewed and interviews, it has been determined that the administrator did not report an incident regarding association of an individual who has been convicted of a crime for which registration as a Registered Sex Offender (RSO) is required, is residing at the facility or has presence/contact that pose immediate a risk to the health and safety of the client(s) in care.
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Additionaly, administrator shall complete training regarding to report such incidents for minimum 4 hours and will submit proof to department by 03/06/24.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder BainsTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2024
LIC809 (FAS) - (06/04)
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