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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700579
Report Date: 05/03/2023
Date Signed: 05/03/2023 01:25:49 PM


Document Has Been Signed on 05/03/2023 01:25 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:CHATEAU AT RIVER'S EDGE, THEFACILITY NUMBER:
342700579
ADMINISTRATOR:MICHAEL TALANIFACILITY TYPE:
740
ADDRESS:641 FEATURE DRTELEPHONE:
(916) 921-1970
CITY:SACRAMENTOSTATE: CAZIP CODE:
95825
CAPACITY:143CENSUS: 86DATE:
05/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Pam MundayTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Case Management Inspection at Chateau at River's Edge (RCFE) on 5/3/23 at 9:00am to address the current administrator status at the facility. LPA met with Regional Director Pam Munday and together conducted a meeting regarding facility administrator.

Per communications provided to the department on 4/19/23, the former administrator's last day working at the facility was 4/19/23. The department had not received an update regarding the appointment of a new administrator. Pam Munday identified that she would be taking over the responsibilities of facility administrator until a permanent candidate is identified. Pam has a current and active Administrator's Certificate which expires on 10/25/2024 and her certificate number is 6021179740.

LPA was informed that the facility is currently conducting interviews for a permanent new administrator. LPA Gould requested the following documents so the department can approve the new administrator:
1. LIC 200 – Application
2. Admin certificate for new administrator
3. LIC 500 - personnel report: updated for all staff and including the times and days the staff will be at the facility
4. LIC 501 – personnel record for new administrator
5. Declaration from the facility board of directors appointing a new administrator.
6. Updated LIC 308 – designation of facility responsibility.
7. Transcripts or college diploma

Report Continued on LIC 809-C
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: CHATEAU AT RIVER'S EDGE, THE
FACILITY NUMBER: 342700579
VISIT DATE: 05/03/2023
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LPA ensured facility staff had the appropriate contact information for LPA's and the department.

LPA also recommended the facility report incidents such as elevator repair/ physical plant issues in the future so the department are aware.

There are no deficiencies cited per California Code Regulation, TITLE 22.

Exit interview was conducted with the facility staff and a copy of this report was left at the facility.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 263-4723
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023
LIC809 (FAS) - (06/04)
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