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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700309
Report Date: 06/06/2023
Date Signed: 06/09/2023 08:26:55 AM


Document Has Been Signed on 06/09/2023 08:26 AM - 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833



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: 5DATE:
06/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:CaregiversTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Kevin Mknelly arrived at the facility unannounced on 6/6/23 to conduct a Required-1 Year Inspection utilizing the infection control domain. LPA met with staff and explained the purpose of the visit. LPA requested for staff to notify Administrator that LPA is present at the facility to conduct an annual inspection. Administrator was unavailable. Inspection completed with designee.

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. The home was found to be clear, safe and sanitary.
LPA advised that the fire door magnet mechanism be inspected for proper operation. LPA advised that an updated facility sketch be submitted to reflect resident and staff rooms.

LPA reviewed 5 resident files and 2 staff files. LPA advised all medication orders be signed (electronic or written), if medications are to be crushed that there is a written order, that the medication administration system does not use pre-poured medications and that emergency drills be recorded for all staff quarterly while residents with dementia are in care.

LPA requested licensee submit a copy of liability insurance.


No deficiencies are being cited as a result of todays inspection.

Exit interview conducted and copy of report left at the facility.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Kevin MknellyTELEPHONE: (209) 814-1925
LICENSING EVALUATOR SIGNATURE:
DATE: 06/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/06/2023
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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