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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700525
Report Date: 04/03/2024
Date Signed: 04/03/2024 11:39:57 AM


Document Has Been Signed on 04/03/2024 11:39 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:ALMOND HEIGHTSFACILITY NUMBER:
342700525
ADMINISTRATOR:MACDONALD, STEPHENFACILITY TYPE:
740
ADDRESS:8685 GREENBACK LNTELEPHONE:
(916) 542-7988
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:145CENSUS: 119DATE:
04/03/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Executive Director, Stephen MacDonald TIME COMPLETED:
11:00 AM
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A virtual meeting was conduct on 04/03/24 with the facility to discuss a situation at the facility regarding resident, R1. Facility Executive Director (ED) , Stephen MacDonald, Facility’s representatives and CCL staff, Regional Manager, Alycia Berryman, Licensing Program Analyst Talwinder Bains, and Licensing Program Manager, Laura Munoz were present. Also in attendance today are representatives from the Long-Term Care Ombudsman (LTCO) , Sacramento County Adult Protective Services (APS), and Department of Justice (DOJ) .

Prior to this meeting, the facility notified the Department that R1’s responsible party has not paid R1’s board and care rate since September 2023 till date. Facility also notified that R1 was admitted to facility in July 2023 and R1s responsible party paid the board and care for July and August 2023. The facility has indicated they have attempted to contact R1’s responsible party but have been unsuccessful. Adult Protective Services and the Long-Term Care Ombudsman has been involved in that it is believed that there is financial misuse of R1’s finances by R1’s responsible party. Facility has issued 30 days eviction notice to R1 due to nonpayment.

During this meeting, it was discussed that APS and CCL will work together to enroll R1 to Assisted Living Waiver (ALW) program so R1 can move to another facility as current facility does not accept residents with the ALW program. It was also discussed that R1 will stay at the facility until appropriate placement is found for R1 per their care needs.

No citations were issued per Title 22 Regulations. Exit interview is conducted with ED via phone.
Copy of the report was sent via email and ED will sign and send it back to LPA via email by 04/03/24 by 5pm.


SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Talwinder BainsTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/03/2024
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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