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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 340317735
Report Date: 12/17/2024
Date Signed: 12/17/2024 10:44:02 AM

Document Has Been Signed on 12/17/2024 10:44 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:TAYLOR HOME II, THEFACILITY NUMBER:
340317735
ADMINISTRATOR/
DIRECTOR:		FILOMENA TAYLORFACILITY TYPE:
740
ADDRESS:3609 PLYMOUTH DRIVETELEPHONE:
(916) 348-8451
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
12/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Filomena TaylorTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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On 12/17/24, Licensing Program Analysts (LPAs) Cheyenne Ratajczak and Graham Gunby arrived unannounced at the facility to conduct a Required 1- year annual inspection utilizing the care tool. LPAs met with Licensee, Filomena Taylor and explained the purpose of the visit.

LPAs and Licensee conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: resident rooms, bathrooms, kitchen, backyard, storage area, and common areas. Hot water temperature was measured at 110 degrees Fahrenheit in kitchen sink, which is within the required range of 105 to 120 degrees. Smoke detectors are current and in compliance with fire safety including carbon monoxide detector. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPAs observed there is sufficient food supplies for seven (7) day non-perishable and two (2) day perishable. LPAs observed toxins and knives to be locked and inaccessible to residents in care. LPAs also observed centrally stored medications are kept locked and inaccessible to residents.

LPA conducted a file review of personnel and residents records.


Exit interview conducted and a copy of the report was left at the facility.
Laura MunozTELEPHONE: (916) 263-4743
Cheyenne RatajczakTELEPHONE: (916) 969-7879
DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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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