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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700595
Report Date: 09/11/2024
Date Signed: 09/11/2024 03:03:20 PM


Document Has Been Signed on 09/11/2024 03:03 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:ALECSANDRU'S LOVING CAREFACILITY NUMBER:
342700595
ADMINISTRATOR:LITA, REBECAFACILITY TYPE:
740
ADDRESS:6129 SUNDAY DRIVETELEPHONE:
(916) 550-0963
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:6CENSUS: 3DATE:
09/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:01 PM
MET WITH:Rebeca Lita, AdministratorTIME COMPLETED:
03:30 PM
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On September 11, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct an Annual inspection. LPA Lyons met with Administrator, Rebeca Lita, whose Administrator certificate expires 7/15/2026. The facilities census is three.

LPA inspected the interior and the exterior of the facility including the common living spaces, resident bedrooms and bathrooms, and kitchen. Bathrooms and bedrooms were clean and in good repair. Food supply is adequate for 2-day perishable and 7-day nonperishable. Smoke alarms were in good working order. Fire extinguisher is ready for emergency use. LPA observed an adequate amount of linens and found the first aid kit to be complete.

LPA reviewed 3 resident record and 2 staff records. Resident files were found to be complete and current. A review of staff records indicates that all facility staff have received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates. Facility is conducting staff training as required.

LPA inspected the exterior of the facility. There are no bodies of water on the premises. LPA observed shaded areas in the backyard. LPA observed garage to be clean and organized.
Medications are locked in a closet in the living room. The MARs was reviewed. The log was up to date and complete.

In the areas that were inspected, no deficiencies were observed.
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 Rebeca.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: DeAnna Williams-LyonsTELEPHONE: (916) 212-3983
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2024
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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