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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700594
Report Date: 10/21/2020
Date Signed: 10/21/2020 10:37:27 AM

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:WOODLAKE, THEFACILITY NUMBER:
342700594
ADMINISTRATOR:SWEARINGEN,MICHELLEFACILITY TYPE:
740
ADDRESS:1445 EXPO PARKWAYTELEPHONE:
(916) 604-3780
CITY:SACRAMENTOSTATE: CAZIP CODE:
95815
CAPACITY:144CENSUS: 21DATE:
10/21/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:06 AM
MET WITH:Michelle Swearingern Executive DirectorTIME COMPLETED:
11:00 AM
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On October 21, 2020 at 9:00am, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived at the facility unannounced to conduct a case management visit. LPA met with Michelle Swearingen and informed her the reason for the visit

On October 8, 2020 the facility had an elopement . The resident was found in the parking lot when discovered. LPA and the executive director discussed the incident in detain and what has been done to improve the security. The facility has taken many step to improve their overall system.

LPA also a 'Wellness Check of the facility and they appear to be doing what required to maintain a non-Covid
positive facility..

Per California Code of Regulations, Title 22, No Citations were issued. An Exit interview was conducted and a copy of this report was given to Michelle Swearingen.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2020
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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