<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700472
Report Date: 01/14/2025
Date Signed: 01/14/2025 02:03:35 PM

Document Has Been Signed on 01/14/2025 02:03 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:VILLAS AT STANFORD RANCH, THEFACILITY NUMBER:
342700472
ADMINISTRATOR/
DIRECTOR:		TYNES, GRAYSONFACILITY TYPE:
740
ADDRESS:1430 W STANFORD RANCH RDTELEPHONE:
(916) 741-7050
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 150TOTAL ENROLLED CHILDREN: 0CENSUS: DATE:
01/14/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Grayson TynesTIME VISIT/
INSPECTION COMPLETED:
02:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
LPA Hiratsuka, conducted this unannounced annual visit. LPA toured the facility with Executive Director Grayson Tynes. This facility has two buildings: one is for memory care that has delayed egress and the larger building has two floors for assisted living. This facility is located on a property that has an independent apartment building that is not licensed by Community Care Licensing Division.
The memory care unit has 20 studio apartments and ten have full private bathrooms and ten have private half bathrooms. There are two outdoor full enclosed atriums, a large common area, dining area, meals are prepared and transported to the memory care unit, a couple of offices, medication room, two locked laundry rooms, a kitchen that is not accessible to the residents that is currently not in use, a salon that is locked when not in use, and a couple of common restrooms for guests.
The assisted living side has a two different style one bedroom apartments; four two bedroom apartments; and eight studio apartments for a total of sixty-six apartments. All apartments have kitchenettes and full private bathrooms. There are two floors. Each floor has several large common areas and common restrooms. There is a salon on the second floor and two locked laundry rooms. The first floor has two laundry room the residents may use if they wish. The first floor also has administration offices to the left of the main entrance. There are several outdoor areas for the residents.

Several topics were discussed.

The following shall be updated and submitted to Community Care Licensing by the end of this month:
-LIC 500 facility personnel or staff schedule
-LIC 610 emergency disaster plan
-LIC 308 designation of administrative responsibility

No deficiencies cited during this visit.
Troy OrdonezTELEPHONE: (916) 263-4700
Kerry HiratsukaTELEPHONE: (916) 591-0210
DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1