342700801-8-12-2026-59-AS-SCAA-DWVQMD-20260812121722

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 342700801
Report Date: 08/12/2026
Date Signed: 08/12/2026 12:17:30 PM

Document Has Been Signed on 08/12/2026 12:17 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:	MINNESOTA HOME CARE		FACILITY NUMBER:	342700801
ADMINISTRATOR/ DIRECTOR:	OKYERE, VERA A.		FACILITY TYPE:	740
ADDRESS:	7448 MINNESOTA DR.		TELEPHONE:	(916) 729-9461
CITY:	CITRUS HEIGHTS	STATE: CA	ZIP CODE:	95610
CAPACITY: 6		CENSUS: 5	DATE:	08/12/2026
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:35 AM
MET WITH:	Vera Okyere, Administrator		TIME VISIT/ INSPECTION COMPLETED:	12:15 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	Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with Administrator, Vera Okyere and staff, Clifford Quarshie. LPA stated the reason for the inspection was to follow up on a recent report received from the Ombudsman's office following their visit on August 4, 2026 (1:30 pm). LPA discussed the Ombudsman's report with the Administrator and staff, and there were several discrepancies noted in the report related to the staff and residents mentioned as being present and a resident name missing from the report who was present. Specifically, the following was noted: The Administrator confirmed she was picking up resident's (R1's) medications from the pharmacy, in the early afternoon, when the Ombudsman arrived to conduct their visit and returned within (10) minutes to the facility. Both the Administrator and staff, Quarshie, confirmed (S1) was present at the start of said inspection and provided documents showing (S1) received a fingerprint clearance/association from the Department on July 29, 2026. LPA obtained photo documentation of the clearance and viewed (S1's) Passport for photo identification. The administrator confirmed (S1) is a relative of hers, and there may have been a language barrier in understanding what the Ombudsman was asking. Resident (R1) was finishing up a stay at a skilled nursing facility on August 4, 2026, due to a Urinary Tract Infection (UTI) related to a catheter, and did not return to the facility until Friday, August 7, 2026. (R1) was sent out to the emergency room yesterday, August 11, 2026, due to another possible UTI, related to the catheter, after Home Health was notified and changed it. Additionally, (R2) moved in on June 15, 2026, and is not noted on the Ombudsman's report, dated August 4, 2026. Staff (S2) was not present on August 4, 2026, as they left to go on vacation around June 4, 2026. LPA reviewed Department documentation showing (S2) was present on May 19, 2026, during a case management inspection. *cont on 809C-1..

Lauren Crocker
Sabrina Calzada
	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: MINNESOTA HOME CARE	FACILITY NUMBER: 342700801
	VISIT DATE: 08/12/2026

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
26
27
28
29
30
31
32

809C-1.. LPA observed (3) locked medication cabinets in the kitchen at the start of today's inspection. The Administrator stated that she changed from using a key lock to a magnetic lock about (3) months ago. LPA observed the sharps drawer to be also locked, using a magnetic lock, as well as the cabinet storage below the kitchen sink. The Administrator will look for and provide documentation as to when the magnetic locks were purchased.

LPA and the Administrator conducted a tour of the facility, including the food on hand. LPA observed fresh eggs, oranges, applesauce and cookies in the main refrigerator and additional perishable food stored in the spare refrigerator in the pantry area. LPA observed a variety of 7+day of non-perishable food in the pantry area that has a future expiration date/s.

LPA reminded the Administrator of the requirement that at least (1) staff always be present with the residents at the facility and how sharps and medications must always be locked, inaccessible to residents.

The Administrator will provide an update on when (R1) returns from the recent hospitalization. LPA and the Administrator also discussed any updates on the a Guardian/Conservatorship for resident (R3).

There are no deficiencies issued in this report.

Exit interview. Copy of report provided.

NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/12/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026

LIC809 (FAS) - (06/04)

Page: 3 of 3