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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001947
Report Date: 11/21/2024
Date Signed: 11/21/2024 05:40:21 PM

Document Has Been Signed on 11/21/2024 05:40 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:EVA'S CARE HOMEFACILITY NUMBER:
347001947
ADMINISTRATOR/
DIRECTOR:
NEMETHY, EVAFACILITY TYPE:
740
ADDRESS:8220 CATALPA DRIVETELEPHONE:
(916) 727-1904
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 6TOTAL ENROLLED CHILDREN: 0CENSUS: 4DATE:
11/21/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:45 PM
MET WITH:Eva Nemethy, Administrator TIME VISIT/
INSPECTION COMPLETED:
05:40 PM
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a required annual.
LPA met with Robert Kovacs, caregiver, and explained purpose of inspection. Administrator, Eva Nemethy, was contacted and arrived at 3:00 pm. LPA observed (3) residents to be in their rooms at the start of the inspection and (1) resident return during the inspection. There are no residents under hospice.

LPA and the Administrator toured the interior and exterior of the facility including the common areas, resident bedrooms (6), resident bathrooms (3), kitchen, staff room and laundry area. LPA observed the facility to be clean, in good repair and odor-free. LPA observed the bathrooms to have the necessary grab bars, non-skid flooring, paper towels, soap and 20-second hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and locked sharps and toxins in the kitchen and locked medications and additional toxins in the laundry room. LPA observed the inside temperature to be 73*F. Hot water measured 112*F in the kitchen. Fire extinguisher is scheduled to be serviced by 11/30/24 and has been pre-paid (last serviced 11/11/23). There is (1) unlocked gate from the inside back patio. There are no bodies of water or a pool.

LPA reviewed (2) of (4) resident files and found them to contain the required paperwork. LPA reviewed medications for (1) resident- orders match medications and documentation is being maintained. LPA reviewed (2) staff files. Both staff have current First Aid and another staff has both First Aid/CPR. Administrator to complete CPR training so a second staff is certified. Documentation shows a main staff completed 25+ hours of required annual training in November 2024. Administrator RCFE Certificate is pending renewal. Administrator created a binder (red) for Emergency Disaster Plan and Infection Control Plan today for easy access.

There were no citations issued; however, there are (2) Technical Violations issued.
Exit interview. Copy of report provided.
Maribeth SentyTELEPHONE: (916) 263-4813
Sabrina CalzadaTELEPHONE: (510) 829-2133
DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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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