<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700963
Report Date: 01/25/2024
Date Signed: 01/25/2024 02:12:36 PM


Document Has Been Signed on 01/25/2024 02:12 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:OARS AT GREENBACK LANE, THEFACILITY NUMBER:
342700963
ADMINISTRATOR:CHRISTAL ANDERSONFACILITY TYPE:
740
ADDRESS:6550 GREENBACK LANETELEPHONE:
(916) 212-0388
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:57CENSUS: 47DATE:
01/25/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Executive Director- Christal AndersonTIME COMPLETED:
02:20 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 01/25/24 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived unannounced at the facility to conduct a required 1-year annual inspection. LPA met with Executive Director (ED), Christal Anderson, (Administrator Certificate #6035240740 Exp. 02/02/24) and explained the purpose of the visit.

Facility is licensed for 57 non-ambulatory residents, hospice waiver of 11. Facility currently has 47 residents,
11 on hospice services.

LPA and ED conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to: twelve (12) resident rooms, laundry room, kitchen, three dining rooms, Beauty Salon, Spa Room, medication room and common areas. LPA observed residents in common area with staff participating in activities. The residence was found to be clean, safe, sanitary and in good condition.

LPA observed the facility to have the mandated posters posted. Fire extinguishers are maintained and ready for emergency use. Facility has required food supplies. There are appropriate staff present to meet the needs of residents.

LPA conducted a file review of five (5) resident files and five (5) staff files. All files had the required documents. LPA also conducted four (4) staff interviews.

In areas toured, LPA did not observed any violation of health, safety and personal rights.

LPA completed the CARE tool and found the facility to be in compliance at this time. No deficiencies observed.

Exit interview conducted and a copy of the report was provided.
SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Cheyenne RatajczakTELEPHONE: (916) 969-7879
LICENSING EVALUATOR SIGNATURE:
DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/25/2024
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 1