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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002892
Report Date: 10/11/2024
Date Signed: 10/11/2024 05:17:51 PM

Document Has Been Signed on 10/11/2024 05:17 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:BLESSINGS CARE HOMEFACILITY NUMBER:
345002892
ADMINISTRATOR/
DIRECTOR:		STEWART, JEFFREYFACILITY TYPE:
735
ADDRESS:7733 GINGERBLOSSOM DRTELEPHONE:
(707) 704-0357
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY: 6CENSUS: 5DATE:
10/11/2024
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
05:00 PM
MET WITH:Karen MutukuTIME VISIT/
INSPECTION COMPLETED:
05:30 PM
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On 10/11/24 Licensing Program Manager (LPM) Troy Ordonez and Licensing Program Analyst (LPA) Graham Gunby arrived unannounced to conduct a case management-health and safety visit. LPAs met with Caregiver Karen Mutuku and explained the purpose of the visit.

Administrator not present during the visit.

During time of visit five (5) resident were present at the facility. LPAs observed there was 2-day perishable, 7-day non-perishable amount of food available. LPA observed resident medications were being stored properly and being dispensed daily to residents. No immediate health, safety, or personal rights violations were observed.

No deficiencies cited during today's visit.

Exit interview conducted.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Graham Gunby
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2024
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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