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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002909
Report Date: 08/13/2024
Date Signed: 08/13/2024 02:28:26 PM


Document Has Been Signed on 08/13/2024 02:28 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:COGIR OF FOLSOMFACILITY NUMBER:
345002909
ADMINISTRATOR:TAYLOR, DEBORAHFACILITY TYPE:
740
ADDRESS:1801 EAST NATOMA STREETTELEPHONE:
(916) 608-0800
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:66CENSUS: 29DATE:
08/13/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Executive Director, Deborah TaylorTIME COMPLETED:
09:15 AM
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On 8/13/2024 at 8:30AM, an informal conference was conducted virtual via Microsoft Teams Meeting. The purpose of this informal conference meeting is to discuss the pending open investigations. Present in the meeting is, Licensing Program Manager (LPM) Anthony Perez, Licensing Program Analyst (LPA) Cassie Yang, and Licensee representatives:
- Deborah Taylor, Executive Director for Cogir of Folsom
- Lyndee Whaley, Regional VP of Operations for Cogir Senior Living
- Phil Altman, Senior VP of Operations for Cogir Senior Living
- Kim Eldridge, Regional Director of Health & Wellness for Cogir Senior Living
- Holly McMurray, Senior VP of Care & Compliance for Cogir Senior Living

The informal conference process was explained during this meeting.

Topic discussed:
- Staffing concerns

At this time, the Department agreed to monitor facility. Additionally, Facility will provide the Department proof of staff training on personal rights of residents.

No deficiencies cited.

Exit interview conducted. Informal meeting concluded and a copy of report will be emailed. Facility Representative Signature is expected to be signed and returned to LPA by close of business, 8/13/2024.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Cassie YangTELEPHONE: (916) 201-1928
LICENSING EVALUATOR SIGNATURE:
DATE: 08/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/13/2024
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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