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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 04:57:27 PM


Document Has Been Signed on 07/09/2024 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: 35DATE:
07/09/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Kylie Whitaker, Administrator TIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection related to an incident report submitted to the Department on 7/2/24. LPA met with Kylie Whitaker, Administrator and Julia Wihl, Business Office Manager, and stated the reason for today's inspection.

LPA was notified by the Administrator, on 7/2/24, that a resident (R1) had exited one of the side exit doors on 7/1/24 (1:32 pm) and the first alarm (30- second Egress alarm) did not alert staff pagers; however, the second alarm, which is activated when the door is opened, was heard throughout the building and multiple staff were able to respond at 1:33 pm.

During the 30-second interval, between the first alarm and second alarm sounding, (R1) was able to walk down the outside ramp, until staff were able to see (R1). At 1:33 pm, multiple care staff heard the alarm and exited the door where (R1) was immediately seen at the end of the ramp. Staff were able to re-direct (R1) back inside. (R1) did not have any injuries or adverse reactions and stated he was "going to work". (R1) was placed on frequent checks, alert charting and will continue to be monitored for any exit-seeking behaviors.

Prior to the incident, exit doors are checked daily for alarm functioning; it is not certain why the pager system was not properly functioning to alert staff when the first alarm went off, and it's possible the excessive outdoor temperatures on 7/1/24, may have contributed to the system not properly functioning.

During today's inspection, LPA observed the first Egress alarm, as well as the second alarm, to be functioning correctly. LPA observed multiple staff responding to the alarms when tested today. Follow up training was conducted with staff, care conference was scheduled and then a care plan was updated.
It appears this was an isolated incident, and there was no explanation as to why the alarm didn't alert the pages on 7/1/24 .

There are no deficiencies issued in this report. Exit interview. Copy of report provided.
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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