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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002804
Report Date: 10/24/2024
Date Signed: 10/24/2024 10:46:46 AM

Document Has Been Signed on 10/24/2024 10:46 AM - 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:ODYSSEY LIFE CENTERFACILITY NUMBER:
345002804
ADMINISTRATOR/
DIRECTOR:
PENMAN, SHELBYFACILITY TYPE:
775
ADDRESS:283 IRON POINTTELEPHONE:
(916) 988-0258
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 30CENSUS: 24DATE:
10/24/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:43 AM
MET WITH:Juanaila Ryan, Program Site CoordinatorTIME VISIT/
INSPECTION COMPLETED:
11:08 AM
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On 10/24/2024 Licensing Program Analysts (LPA) DeAnna Williams-Lyons arrived at the facility unannounced to conduct an annual one year inspection. LPA met with Program Site Coordinator , Juanaila Ryan and explained the purpose of the visit. The temperature in the facility was 68 degrees F.

LPA's tour of the facility included but not limited to: common areas, restrooms, kitchen area, supply room, recreational area,and the outside area. Restrooms were clean and in good repair. Smoke alarms were checked and in good working order. Fire extinguishers were managed and are in good working order. Fire drills are conducted as required. Hot water temperature was tested and measures at 110 degrees F.

The facility does not administer medications to their clients. Facility does provide lunches and go on outings twice a day. The kitchen area was clean and have tables and chairs for their clients. Sharp objects and cleaning supplies were made inaccessible.

LPA conducted a file review of 2 staff members and 3 clients records. LPA observed that all staff files have current documents as well as the Criminal Clearances, Contact Information, Health Screenings and First Aid and CPR Certificates. Client files were current and included the required Admission Agreements, Contact Information, Physician Reports and Individual Program Plans.

LPA and Juanaila completed the Care Tool Questionnaire with no issues or concerns. The facility have not had Covid-19 within the last year. The clients and staff were not able to be interviewed due to an outing they were on.

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 Juanaila.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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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