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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 04/16/2024
Date Signed: 04/16/2024 03:28:50 PM


Document Has Been Signed on 04/16/2024 03:28 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:
04/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Kylie Whitaker, Administrator TIME COMPLETED:
02:45 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 quarterly on-site case management inspection pursuant to a Stipulation and Waiver and Order adopted on 08/19/2022. LPA met with Kylie Whitaker, Administrator, and Jasmine Juchniewicz, Health and Services Director, and stated the reason for today's inspection.

During today's inspection, LPA reviewed the "Compliance Binder" and observed it to be organized and contain tab dividers for each requirement as set forth in in the Stipulation. LPA observed current documentation for the following requirements:
  • Quarterly Medication Audit - training conducted by an outside Pharmacy RN, in March 2024 for months January -March 2024.
  • High risk residents- LPA observed weekly notes filed, thru 3/30/24, written by HSD based on weekly meeting with facility nurses and Med-Techs every Wednesday.
  • Weekly door checks for alarms and obstruction of door exits. LPA observed documentation on each log to be for the last 3 months to have been initialed as completed.
  • Weekly elopement drills continue were conducted in January/February and monthly drills in March 2024. Stipulation only requires monthly drills be conducted. LPA reviewed documentation on file.
  • January 18 - March 28, 2024 training documentation on file for scheduled training every Thursday. LPA reviewed training documentation and observed a variety of topics including: hospice care, choking/aspiration, effective communication, perineal care, fire drill, and transfers.


LPA conducted a health and safety tour of the inside of the facility and did not observe any health and safety risk or personal rights violation. LPA observed many residents to be enjoying activities in the activity room and others to be napping in their rooms. Staff were preparing for the ice-cream social with families today. There is a family BBQ planned for Earth Day later this month.

There are no citations issued on this report. The next quarterly inspection to be conducted on/around July 2024.

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: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024
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