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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001498
Report Date: 05/10/2023
Date Signed: 05/11/2023 11:20:34 AM


Document Has Been Signed on 05/11/2023 11:20 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833



FACILITY NAME:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR:TINA NEWTON-SMITHFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:45CENSUS: 42DATE:
05/10/2023
TYPE OF VISIT:CollateralANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Robert Godfrey, Regional Director and Mark Cimino, CEO TIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Sabrina Calzada attended a meeting on 5/10/23 from 10:00- 11:00 am with the Ombudsman assigned to the facility, the supervising Ombudsman, and Robert Godfrey, Regional Director and Mark Cimino, CEO of the facility. The meeting was held at an office location for the facility due to a current Covid outbreak at the facility. LPA was invited to attend the meeting by the assigned Ombudsman since she is the assigned analyst to the facility.

During the meeting, areas of recent concerns at the facility were discussed and noted, including staff reporting requirements and staffing levels. Information on Family Councils was provided by the Ombudsman who also offered to assist as needed to implement one at the facility.

CEO stated the Regional Director is the first point of contact for the facility since he is most aware of the daily events at the facility.

Regional Director agreed to provide additional documentation to the Department that was requested on 5/9/23 by LPA.

There are no citations issued on this report.

A copy of this report was written and emailed to the Regional Director for a signature at approximately 4:45 pm on 5/10/23.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2023
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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