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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 05/10/2023
Date Signed: 05/10/2023 01:29:33 PM


Document Has Been Signed on 05/10/2023 01:29 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: 21DATE:
05/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Andrea Armstrong, Administrator TIME COMPLETED:
01:30 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 conduct a case management inspection to follow up on a recent email report to the Department regarding a fire in the facility van outside.
LPA met with Andrea Armstrong, Administrator and Kylie Whitaker, Health Services Director (HSD), and explained purpose of inspection. LPA observed a large Fire Department truck to be in the parking lot at the start of the inspection.

During today's inspection, LPA, Administrator and HSD discussed a fire that broke out, yesterday, 5/9/23, in the facility van that was parked outside in the facility parking lot.. LPA observed the fire-damaged vehicle to be parked in the parking lot. Administrator stated the Fire Department was at the facility yesterday to investigate the fire for potential arson, and she was informed that the fire didn't meet the criteria for arson, and the cause is unknown.

Administrator indicated the flame started at the back of the bus at approximately 2:00 am and the van will be removed once all follow up inspections have been completed. There were no residents or staff involved or near the vehicle. LPA took a photo of the damaged van.

Administrator stated that the van hadn't been used/moved since February 2023, and the facility is planning to obtain a rental van as a replacement.

LPA requested an incident report (LIC624) be submitted to the Department within (7) days of the occurrence.
There are no deficiencies issued in this report.

Exit interview. Copy of report provided to the facility.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2023
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