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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345920230
Report Date: 06/05/2026
Date Signed: 06/05/2026 04:21:21 PM

Document Has Been Signed on 06/05/2026 04:21 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:CITRUS HEIGHTS SENIOR LIVINGFACILITY NUMBER:
345920230
ADMINISTRATOR/
DIRECTOR:		SAHOTA, SUKHMANFACILITY TYPE:
740
ADDRESS:8440 EDGECLIFF COURTTELEPHONE:
(916) 242-0811
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6CENSUS: 5DATE:
06/05/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Onejeh Jones, caregiver and Jackie Cole-Cochrane, caregiver TIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with staff, Onejeh Jones and Jackie Cole-Cochrane. LPA stated the reason for the inspection was to follow up on (2) incident reports recently submitted to the Department. LPA discussed the incident reports (2) with the Administrator, by phone. All residents were napping in their rooms.

On May 26, 2026, the administrator received a phone call from the day program that resident (R1) reported that facility staff had taken their cigarettes. Staff Jones stated she found the alleged missing cigarettes (1 pack) under (R1's) pillow. The administrator stated (R1) short-term memory loss and is confused/disoriented some of the time, and (R1) has a habit of misplacing items often. The administrator stated the new issue with (R1) is a friend gives (R1) more cigarettes while they are attending day program, but doesn't give them to the staff when returning to the care home. (R1) is aware of the house rules now and will allow staff to safeguard, with a lighter, and ask for them, when desired. Staff Jones showed LPA a large ziploc bag where multiple packs of cigarettes and a lighter are securely stored.

On May 26, 2026, resident (R2) received a full shower after the hospice nurse provided clearance. (R2) received bed baths due to transfer concerns related to a very swollen ankle when moving in in April 2026. After this bath, (R2) tried to get up multiple times, but staff told her to call for assistance. (R2) was able to slide to the end of the bed and sustain a skin tear and sore back while slipping out of bed. Hospice staff was notified and arrived to provide first aid/skin tear care. Staff Jones stated the hospice nurse was last here Wednesday, this week, and changed the dressing. LPA observed bed pads covering full bed rails on (R2's) bed. LPA also observed (R2) to be resting comfortably and wearing clean dressing on their left forearm. The administrator and staff continually remind (R2) to use their call button, and staff regularly check on (R2), leaving the door open. It appears the facility took appropriate and timely action in both incidents. There are no deficiencies issued in this report. Exit interview with Staff Jones. Copy of report provided.
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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