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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700284
Report Date: 11/04/2020
Date Signed: 11/04/2020 12:34:07 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:MINNESOTA HOME CAREFACILITY NUMBER:
342700284
ADMINISTRATOR:OKYERE, VERAFACILITY TYPE:
740
ADDRESS:7448 MINNESOTA DRIVETELEPHONE:
(916) 842-9025
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 4DATE:
11/04/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Vera Okyere, AdministratorTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Bethany Huusfeldt, LPM Maribeth Senty, and Regional manager Alycia Berryman met with administrator Vera Okyere and licensee Heinrette Donkor for an informal meeting. CCL met with administrator and licensee over team meetings due to covid precautions.

During today's visit CCL discussed the following:
  • Facilities recent complaints from 2019 to current.
  • Recent citations
  • Covid precautions
  • Prohibited conditions and requirements
  • Recent PIN's
  • Disaster plan- LIC610E
  • Surveillance testing and flu vaccinations
  • Caregiver training

Administrator and licensee agreed to send in the following information by Monday 9th by 5 PM:
  • Testing plan
  • Updated Disaster plan
  • Mitigation plan
  • Staff training for 2020


Exit interview conducted. A copy of report was sent to administrator and licensee.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Bethany HuusfeldtTELEPHONE: (916) 591-1072
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2020
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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