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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001241
Report Date: 02/21/2024
Date Signed: 02/21/2024 01:03:06 PM


Document Has Been Signed on 02/21/2024 01:03 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:ESKATON GOLD RIVER LODGEFACILITY NUMBER:
347001241
ADMINISTRATOR:NEAL TORRESFACILITY TYPE:
740
ADDRESS:11390 COLOMA RDTELEPHONE:
(916) 852-7900
CITY:GOLD RIVERSTATE: CAZIP CODE:
95670
CAPACITY:134CENSUS: 86DATE:
02/21/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Neal TorresTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Vincent Moleski arrived unannounced to follow up on corrections made following a non-compliance conference on 10/31/23. LPA Moleski met with facility administrator Neal Torres and explained the purpose of the visit.

LPA Moleski and Torres discussed systems currently place to address areas of concern expressed during the non-compliance conference, including but not limited to: medication administration, training programs, medication storage, medication administration record-keeping, changes in condition, and observation of residents.

LPA Moleski reviewed documentation pertaining to a compliance nurse audit of medications and medication records, and notes from weekly care coordination meetings held by facility leadership.

No deficiencies were cited during this visit. An exit interview was held and a copy of this report was left with Torres.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Vincent MoleskiTELEPHONE: (559) 365-5294
LICENSING EVALUATOR SIGNATURE:
DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/21/2024
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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