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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700471
Report Date: 02/11/2025
Date Signed: 02/11/2025 12:28:49 PM

Document Has Been Signed on 02/11/2025 12:28 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:COGIR OF STOCK RANCHFACILITY NUMBER:
342700471
ADMINISTRATOR/
DIRECTOR:		DAVID JR., RICKYFACILITY TYPE:
740
ADDRESS:7418 STOCK RANCH RDTELEPHONE:
(916) 725-7418
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 99TOTAL ENROLLED CHILDREN: 0CENSUS: 77DATE:
02/11/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Administrator, Ricky David Jr.TIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On February 11, 2025 at approximately 10:15 AM, Licensing Program Analysts (LPA), Farhaan Sarangi and Kayla Adkison met arrived unannounced at Cogir of Stock Ranch for the purpose of conducting a Required 1 year inspection. LPA was greeted at the door by, Administrator, Ricky David Jr. and was granted access into the facility.

LPAs and Administrator toured the facility. LPA observed the facility to be clean and at a comfortable temperature with all exits free from obstruction. LPAs observed a chair lift that is utilized in event of emergencies in the 3rd floor stairwell. LPA observed 1 out of 2 elevator permits not being displayed in the elevators (See LIC 9102-Technical Violation). Fire Extinguishers were found to be last charged on March 2024 at the time of the inspection. All smoke detectors sound directly to the fire station. Water temperature in facility bathroom is within Title 22 Regulation. LPA observed sufficient perishable and non-perishable foods located in the kitchen. There are special provisions made for individuals with special dietary needs. Food menu was presently available for viewing during the inspection. Medications were centrally stored and locked. Cleaning products and other toxins are located in the laundry room that was locked and inaccessible to residents in care. There was a supply of linens, cleaners, hygiene products and paper products available for residents. All bathrooms designated for residents in the common areas at the facility were supplied with individual paper towels and hand soap. Bathrooms in resident’s rooms have a towel and soap. Bathrooms were equipped with necessary grab bars, and non-slip floors/mats were present. A tour of vacant and occupied bedrooms were conducted, and bedrooms inspected have lighting and appropriate furnishing. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms of COVID-19 or other infectious diseases are present in the facility. First Aid kit was inspected and found to be appropriate during the inspection. Emergency Disaster Drill was last conducted in July 2024.

(Report continued on LIC 809C)
Lauren CrockerTELEPHONE: (916) 202-0832
Farhaan SarangiTELEPHONE: (916) 307-0474
DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: COGIR OF STOCK RANCH
FACILITY NUMBER: 342700471
VISIT DATE: 02/11/2025
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LPA reviewed 5 of 5 resident files and found those to be appropriate. LPAs reviewed 5 of 5 resident medication orders. However, during that review, LPA observed that 1 out of 5 residents had a discrepancy in the medication orders. LPA educated the Administrator on the importance of ensuring that documentation is up to date (See LIC 9102-Technical Violation). Administrator reported that he will follow-up with the Primary Care Physician and the Pharmacy. LPA reviewed staff files and found those files to be appropriate during the review. LPA requested the following documents to be sent:

LIC 500- Personnel Report
LIC 308- Designation of Facility Responsibility
LIC 309- Administrative Organization
Most up-to-date Liability insurance
Emergency Disaster Plan
Control of Property
Register of residents
Most updated Infection Control Plan
Most recent Fire Inspection Report

No deficiencies were cited during today's Required 1 year inspection. Exit interview was conducted, and a copy of this report was given to the Administrator.
SUPERVISOR'S NAME: Lauren CrockerTELEPHONE: (916) 202-0832
LICENSING EVALUATOR NAME: Farhaan SarangiTELEPHONE: (916) 307-0474
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC809 (FAS) - (06/04)
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