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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700077
Report Date: 11/22/2022
Date Signed: 11/22/2022 04:44:26 PM


Document Has Been Signed on 11/22/2022 04:44 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926



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: 17DATE:
11/22/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Kylie Whitaker, Health Services Director TIME COMPLETED:
04:00 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 required annual inspection. LPA met with Kylie Whitaker, Health Services Director, and explained purpose of inspection. LPA spoke with Administrator, Andrea Armstrong, by phone during the inspection also. Prior to initiating today's inspection, LPA completed required COVID-19 protocols and confirmed there are no positive cases currently at the facility. Additionally, LPA was screened per Covid-19 precautionary measures upon entering the facility and was wearing a surgical mask. The facility is licensed for 48 non-ambulatory residents who have a diagnosis of Dementia, 12 of whom may be bedridden, and has a hospice waiver for 12 residents. There are currently 4 residents on hospice.

LPA and the Health Services Director toured the interior and exterior of the facility including the medication room, dining rooms, activity room, salon, kitchen, staff lounge and common areas. LPA observed the facility to be clean, in good repair, odor free and the bathrooms to have paper towels, soap, trash cans with lids. LPA observed a 20-second hand-washing poster above each bathroom and kitchen sink. Fire extinguishers observed throughout and to have last been serviced on 2/8/2022. All (3) exit doors and front entrance door are equipped with an egress door alarm. LPA observed hand sanitizers in the common areas and required postings displayed. There is an enclosed courtyard with gardening planters for residents. LPA observed the inside temperature to be 73*F. LPA observed multiple staff present and was advised there is a nurse on site 24/7, 5 days per week. LPA, HSD and Administrator completed the Infection Control Domain tool during today's inspection.

LPA requested a copy of LIC308, LIC500 and current liability insurance be emailed to CCLD by 11/30/2022.

There were no deficiencies observed during today's inspection. Exit interview. Copy of report provided to HSD.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2022
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