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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700050
Report Date: 02/22/2024
Date Signed: 03/13/2024 09:02:47 AM


Document Has Been Signed on 03/13/2024 09:02 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: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: 4DATE:
02/22/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Atanas ManevTIME COMPLETED:
11:46 AM
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On 2/22/2024, Licensing Program Analyst (LPA) Cassie Yang arrived unannounced at the facility to conduct a Required annual inspection utilizing the CARE tool. LPA met with Administrator and explained the purpose of the visit.

During today's visit, LPA and Administrator conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: six private residents room, three caregiver rooms, kitchen, laundry room, backyard and the common areas. LPA observed the posted license to be incorrect to current licensure of hospice waiver for four. LPA informed Administrator a new license will be sent to the facility as soon as possible.

LPA observed facility to have ample supply of perishable and non perishable foods. LPA observed medications, toxins and sharps to be stored separately and to be inaccessible to residents in care.

LPA conducted a file review for three residents and three staff. LPA observed the required documents to be present in the binders.

Administrator and LPA discussed there is no concerns at the facility. Administrator reported no concerns with staffing.

CARE tool completed and facility was found to be in substantial compliance with California Code Regulation, Title 22.

Exit interview and a copy of the report will be provided to Administrator via email.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: (916) 201-1928
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2024
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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