342700579-11-6-2024-27-AS-KVIA-DAS3LP-20241106172104

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342700579
Report Date: 11/06/2024
Date Signed: 11/06/2024 05:21:24 PM

Document Has Been Signed on 11/06/2024 05:21 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	CHATEAU AT RIVER'S EDGE, THE		FACILITY NUMBER:	342700579
ADMINISTRATOR/ DIRECTOR:	MARIANNE R RICHARDSON		FACILITY TYPE:	740
ADDRESS:	641 FEATURE DR		TELEPHONE:	(916) 921-1970
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY: 143	TOTAL ENROLLED CHILDREN: 0	CENSUS: 78	DATE:	11/06/2024
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Marianne Richardson		TIME VISIT/ INSPECTION COMPLETED:	05:30 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	On 11/06/24, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct an annual inspection. LPA identified herself upon arrival, stated the purpose of the visit and asked to meet with the Designated Facility Administrator/Executive Director (ED), Marianne Richardson. The two met and a brief interview followed. The ED escorted the LPA through the building where the LPA observed the following: a housekeeper servicing rooms on the first floor. In assisted living, this LPA observed 9 residents outside the private dining room playing a trivia game led by a staff member. In memory care this LPA observed 4 residents participating in chair yoga exercises led by a staff member. During the tour this LPA checked to ensure that all fire extinguishers had been serviced, in this case by Johnson Controls, and were in compliance at the time of inspection. LPA inspected the medication cart and compared medications prescribed for R1 to the medications in the cart. All was in order and no errors were located. LPA also inspected the cart for expired medications and found none at the time of inspection. This LPA reviewed the policies and procedures for administering and destroying medications as well as the procedures for administering PRNs. Technical assistance was provided regarding information found in the California Department of Social Services Medications Guide. This LPA also reviewed the facility's first aid kit to ensure it contained the required components. All was in compliance at the present time. LPA inspected a sample of resident rooms. Each had the required furniture, furnishings, and lighting to be in compliance at the present time. Bathrooms also contained the required grab bars and non-skid surfaces in the showers. LPA measured the hot water in a resident bathroom to ensure it was between 105 and 120 degrees Fahrenheit. LPA conducted an external inspection of the facility. There were no external bodies of water present. All windows, window screens, gutters and patio areas were free of debris and in good repair.

Stephen Richardson	TELEPHONE: (916) 263-4746
Kimberly Viarella	TELEPHONE: (916) 809-5764
	DATE: 11/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHATEAU AT RIVER'S EDGE, THE	FACILITY NUMBER: 342700579
	VISIT DATE: 11/06/2024

NARRATIVE

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LPA then went on to conduct a review of 3 resident files. Resident files were complete at the time of inspection. LPA reviewed a sample of 3 staff files. LPA observed documentation for training through an online learning system. LPA provided additional technical assistance with regards to the types of training that the regulations require.

LPA toured the dining room where she observed 18 residents having lunch. LPA inspected the kitchen where the following pantry items were found after their "best if used by" date: 3 cans of Crisco - 12/02/22, 5 containers of grits- (1) 05/21/24, (2) 08/13/24, (1) 07/01/24. LPA also found a half-full bottle of teriyaki sauce that was supposed to be refrigerated after opening. According to Title 22 of the California Code of Regulations, this deficiency was cited on the LIC 809D page.

No additional deficiencies were cited during today's inspection. A copy of this report was provided along with a copy of APPEAL RIGHTS and an exit interview was conducted with Marianne Richardson.

SUPERVISOR'S NAME: Stephen Richardson	TELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly Viarella	TELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/06/2024 05:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHATEAU AT RIVER'S EDGE, THE	FACILITY NUMBER: 342700579
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

General Food Service Requirements

(b) The following food service requirements shall apply: (8) All food shall be of good quality. Commercial foods shall be approved by appropriate federal, state and local authorities. Food in damaged containers shall not be accepted, used or retained. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA's observation of 8 items that were still on the pantry shelves after their best by date and 1 item that was supposed to be refrigerated, the licensee did not comply with the section cited above. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/06/2024
	Plan of Correction
1 2 3 4	Executive Director will submit a plan for a monthly expiration date check of all food items to kimberly.viarella@dss.ca.gov by 11/13/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Stephen Richardson	TELEPHONE: (916) 263-4746
Kimberly Viarella	TELEPHONE: (916) 809-5764
	DATE: 11/06/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024

LIC809 (FAS) - (06/04)

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