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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700731
Report Date: 09/27/2024
Date Signed: 09/27/2024 01:11:52 PM


Document Has Been Signed on 09/27/2024 01:11 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:LOVE AND COMFORT ELDERLY CAREFACILITY NUMBER:
342700731
ADMINISTRATOR:CLEOPATRA GARDINERFACILITY TYPE:
740
ADDRESS:6532 RANCHO GRANDE WAYTELEPHONE:
(916) 594-9378
CITY:SACRAMNETOSTATE: CAZIP CODE:
95828
CAPACITY:6CENSUS: 3DATE:
09/27/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:04 PM
MET WITH:Cleopatra GardinerTIME COMPLETED:
02:00 PM
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on 9/27/24 Licensing Program Analyst (LPA) Kevin Gould conducted an unannounced Plan of Correction (POC) inspection to ensure all previously cited deficiencies have been corrected. LPA met with administrator and conducted a walk through of the facility to ensure all resident rooms are set up as approved by the department. LPA observed all written plans of correction have been completed and meet requirements for POC. LPA has confirmed personal rights training has been schedule with Yolo Hospice to be completed on 9/27/24.

Per California Code of Regulations, Title 22, there are no deficiencies observed during today's inspection.

Exit interview conducted and a copy of this report and POC clearance letter were left at the facility.
SUPERVISOR'S NAME: Czarrina A Camilon-LeeTELEPHONE: (916) 214-5136
LICENSING EVALUATOR NAME: Kevin GouldTELEPHONE: (619) 672-5924
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2024
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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