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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342701306
Report Date: 12/10/2024
Date Signed: 12/10/2024 04:16:18 PM

Document Has Been Signed on 12/10/2024 04:16 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:MEADOWS SENIOR LIVING, THEFACILITY NUMBER:
342701306
ADMINISTRATOR/
DIRECTOR:
SELLERS, ALYSSAFACILITY TYPE:
740
ADDRESS:9325 EAST STOCKTON BLVD.TELEPHONE:
(916) 877-7835
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 160CENSUS: 89DATE:
12/10/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Alyssa SellersTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 12/10/2024, Licensing Program Analyst (LPA) Arvin Villanueva arrived at this facility unannounced to conduct their required annual visit. LPA met with Executive Director/Administrator Alyssa Sellers (ADM) and stated the purpose of the visit. This facility currently approved to retain/accept 10 hospice residents and fire cleared to retain/accept 24 bedridden residents. Note that bedrooms and non-ambulatory bedrooms are interchangeable.

The LPA and ADM toured the facility to verify compliance with Title 22 regulations. The facility is a two-story building, with memory care located on the first floor. It has a capacity of 160 residents, serving both assisted living and memory care. The LPA inspected the first and second floors, activity rooms, dining room, cinema room, elevator, and resident apartments/units. Each floor is equipped with a medication room, and medications were found to be securely stored, locked, and inaccessible to residents. The resident apartments/units are spacious enough to accommodate personal furnishings, and all 4 observed units were clean, sanitary, and free of obstructions. Each observed bedroom had a smoke and carbon monoxide detector, and the memory care rooms were equipped with electronic monitoring systems installed on the ceiling to detect falls and notify staff. Memory care also has delayed egress doors.

The LPA observed the kitchen area to be clean and sanitary. The facility maintains a minimum of two days’ worth of perishable food and seven days’ worth of non-perishable food. The LPA reviewed the menu and activity calendar, and the Administrator confirmed that each resident is provided with a copy of both. During the visit, kitchen staff were preparing dinner.

The LPA noted a shaded area in the yard with tables and chairs, and the outdoor activity area is secure for dementia residents. The outdoor passageways, walkways, driveways, and steps were free from obstructions and hazards. The facility does not have any bodies of water.

Water temperatures in 4 selected bathrooms (within resident apartments/units) were recorded between 113°F and 114°F. Room temperatures in the 4 observed resident apartments/units ranged from 69°F to 78°F.

Due to time constraints, this annual visit will require a continuation visit. An exit interview was conducted with the Alyssa Sellers and , and a copy of this report was provided.

SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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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