<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 04/19/2023
Date Signed: 04/19/2023 02:39:26 PM


Document Has Been Signed on 04/19/2023 02:39 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:COURTE AT CITRUS HEIGHTS, THEFACILITY NUMBER:
342700077
ADMINISTRATOR:ARMSTRONG, ANDREAFACILITY TYPE:
740
ADDRESS:6825 SUNRISE BLVDTELEPHONE:
(916) 721-0644
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:48CENSUS: 20DATE:
04/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Andrea Armstrong, Administrator TIME COMPLETED:
02:40 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conclude and deliver findings to a complaint received on 3/14/23. LPA met with Andrea Armstrong, Administrator, and explained purpose of inspection. LPA completed required COVID-19 department protocols and was wearing a surgical mask.

During the complaint investigation, it was alleged that the facility did not notify all individuals involved in resident's (R1) status of its probationary status with the Department.

LPA reviewed R1's file as well as (4) additional residents (R2-R5) and was provided with copies of signed acknowledgements from each resident's responsible person. LPA confirmed that R1's family member signed the acknowledgement on 2/25/23, prior to resident moving in on 2/28/23.

Additionally, the facility's Administrator and Marketing Director indicated that the National Placement and Referral Alliance (NPRA) receives regular communications regarding all licensed facilities' status with the Department.

Administrator confirmed the signed acknowledgements are maintained in the same file with each resident's admission documentation.

There are no deficiencies issued on this report.

Exit interview. Copy of report provided to Administrator.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1