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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 07/09/2024
Date Signed: 07/09/2024 04:56:21 PM


Document Has Been Signed on 07/09/2024 04:56 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: 35DATE:
07/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Kylie Whitaker, Administrator TIME COMPLETED:
03:30 PM
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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 Julia Wihl, Business Office Manager and stated the reason for today's inspection.

LPA, Administrator and Business Office Manager reviewed the "Compliance Binder", where all documentation related to the stipulation requirements is filed.
  • Weekly staffing schedules for months April- June 2024 showing staffing coverage.
  • Quarterly Medication Audit - training conducted by an outside Pharmacy RN, in 2024 June, 2024 for months 2024. April- June, 2024.
  • High risk residents- LPA observed weekly notes filed, thru 6/26/24, 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 by Maintenance Director, Administrator. Additional staff check to ensure egress alarms are working.
  • Weekly to monthly elopement drills were completed April- June, 2024. Stipulation only requires monthly drills be conducted. LPA reviewed documentation on file.
  • April- June, 2024 training documentation for scheduled training every week. LPA observed a variety of topics including: hoyer lift, showers, medication training, proper hydration for residents, especially during hot, summer months. Administrator stated the community has (2) water stations on site and staff will check on residents every 15 minutes on days with excessive heat outside.

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.

There are no citations issued on this report. The next quarterly inspection to be conducted on/around October 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: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/09/2024
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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