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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700309
Report Date: 06/15/2022
Date Signed: 06/15/2022 03:26:50 PM


Document Has Been Signed on 06/15/2022 03:26 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:D&T LIVING SOLUTION HOME CAREFACILITY NUMBER:
342700309
ADMINISTRATOR:SAVENCO, TATIANAFACILITY TYPE:
740
ADDRESS:2829 PANAY CTTELEPHONE:
(916) 417-6264
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:6CENSUS: 6DATE:
06/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:TATIANA SAVENCOTIME COMPLETED:
03:45 PM
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Licensing Program Analyst (LPA) Cassie Yang arrived at the facility unannounced on 06/15/2022 to conduct a Required-1 Year Inspection. LPA met with caregiver, Audrie Brown, and explained the purpose of the visit. Prior to initiating the annual inspection, LPA completed required COVID-19 testing protocols, and a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: Surgical Mask. Additionally, LPA was screened by facility staff upon entering the facility.

LPA toured the interior and exterior of the facility together with staff to ensure health and safety of residents in care. Areas toured include but are not limited to: common areas, resident bedrooms, bathroom, kitchen, laundry room, and backyard. In the areas toured no immediate health, safety, or personal rights violations were observed. LPA and Administrator followed the infection control domain guidelines and facility was found to be in substantial compliance at this time.

LPA observed the temperature of the facility to be 75*. LPA reviewed a record daily temperature screening of residents. LPA observed the fire extinguisher to be up to date with last inspection to be July 2, 2021. LPA observed the Administrator Certificate #6043861740 to be up to date with the expiration date of 06/23/2023.

No deficiencies are being cited as a result of today's inspection.

Exit interview conducted and copy of report left at the facility.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 06/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/15/2022
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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