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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 03/26/2024
Date Signed: 03/26/2024 04:57:15 PM


Document Has Been Signed on 03/26/2024 04:57 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:COURTE AT CITRUS HEIGHTS, THEFACILITY NUMBER:
342700077
ADMINISTRATOR:KYLIE WHITAKERFACILITY TYPE:
740
ADDRESS:6825 SUNRISE BLVDTELEPHONE:
(916) 721-0644
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:48CENSUS: 39DATE:
03/26/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:10 PM
MET WITH:Julia Wihl,Business Office Manager and Jasmine Juchniewicz, Health and Services Director.TIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection to discuss staffing level increases with the recent additional move-ins since on/around 2/28/24. LPA met with Julia Wihl, Business Office Manager and Jasmine Juchniewicz, Health and Services Director.

LPA obtained copies of weekly staffing schedules from 2/25/24 through 3/24/24 and reviewed the schedules which reflect additional staff that have been recently hired and any staff call-outs. The Business Office Manager stated new staff have been hired for all shifts and include caregivers, Med-Techs and a nurse.

The Business Office Manager confirmed there are (2) additional residents that will move in on Thursday, 3/28/24, from the related community, and there will be an additional staff that will transfer also.

LPA will follow up with any additional questions or if additional documentation is needed.

There are no deficiencies cited in this report.

Exit interview. Copy of report provide to the Health and Services Director.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/26/2024
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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