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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700427
Report Date: 01/16/2025
Date Signed: 01/16/2025 02:19:26 PM

Document Has Been Signed on 01/16/2025 02:19 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:WOODVIEW CARE HOMEFACILITY NUMBER:
342700427
ADMINISTRATOR/
DIRECTOR:
NEGRU, INGRID DIANAFACILITY TYPE:
740
ADDRESS:120 WOODVIEW DRTELEPHONE:
(773) 318-3588
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 6CENSUS: 6DATE:
01/16/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:10 PM
MET WITH:Ingrid Negru, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Cassandra Mikkelson arrived unannounced to conduct an annual inspection. LPA met with Administrator Ingrid Negru during today's inspection.

LPA conducted an inspection of the care home to ensure compliance with Title 22 regulations. LPA observed six (6) resident rooms, one (1) staff room, two (2) common area bathrooms, common living room and kitchen. LPA observed rooms to be properly furnished, with appropriate bedding and lighting. The bathrooms were in sanitary condition and properly maintained and the hot water temperature was observed to be 116.9 degree F.

LPA checked the kitchen area for the ability to prepare and store food. Care home has required (2) two day perishable and (7) seven day non-perishable food supply on hand. Smoke detectors and carbon monoxide detectors are operational in the care home. Fire extinguisher and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medications to be locked away and inaccessible to the residents.

LPA reviewed six (6) resident files, two (2) staff files and two (2) resident medications. Facility has a current copy of certificate of liability insurance and LPA requested a copy.

As a result of this visit, no deficiencies were cited. Exit interview was conducted with Administrator.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Cassandra Mikkelson
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
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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