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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700050
Report Date: 03/29/2023
Date Signed: 03/29/2023 03:38:28 PM


Document Has Been Signed on 03/29/2023 03:38 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:OAKS AT GARFIELD, THEFACILITY NUMBER:
342700050
ADMINISTRATOR:MANEV, ATANAS MFACILITY TYPE:
740
ADDRESS:3500 GARFIELD AVETELEPHONE:
(916) 342-9695
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 5DATE:
03/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Atana ManevTIME COMPLETED:
03:30 PM
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On 03/29/2023, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a Required 1-year annual inspection. LPA met with Administrator, Antana Manev, and explained the purpose of the visit.

Prior to entering the facility, LPA observed the facility to be in the middle of exterior renovations. Administrator informed LPA the driveway is currently getting re-done but the rain has delayed the cementing. LPA was informed once the rain ends, the driveway will be completed shortly.

There are currently (5) residents residing at this facility, facility is licensed for 6. There are no residents who have restricted health care conditions and no residents who are currently receiving wound care. This facility has a hospice wavier for 2 and currently has 1 residents on Hospice services.

LPA and Administrator conducted a tour of the interior of the facility including the common areas, resident bedrooms, staff bedrooms, bathrooms, and kitchen. Bathrooms and bedrooms were clean and in good repair. There is a locked storage for medications, sharps and toxins. Food supply is adequate for 2-day perishable and 7-day nonperishable. LPA observed documentation of fire drills conducted.

LPA requested a copy of LIC 500, Administrator Certificate(s) and liability insurance to be emailed ton LPA by April 5, 2023.

LPA and Administrator completed the full CARE tool and the facility was found to be in compliance.

As a result of todays inspection, observations, and interviews, no deficiencies were observed or cited.

Exit interview conducted with Administrator and report copy provided.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: 916-201-1928
LICENSING EVALUATOR SIGNATURE:
DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/29/2023
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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