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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003712
Report Date: 07/15/2021
Date Signed: 07/15/2021 04:37:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:BROOKDALE CITRUS HEIGHTSFACILITY NUMBER:
347003712
ADMINISTRATOR:ALEJANDRA C SALLEEFACILITY TYPE:
740
ADDRESS:7375 STOCK RANCH RDTELEPHONE:
(916) 729-2722
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:56CENSUS: DATE:
07/15/2021
TYPE OF VISIT:Case Management - Legal/Non-complianceANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Christine Salle, AdministratorTIME COMPLETED:
03:00 PM
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A non-compliance conference was conducted today via Microsoft Teams due to COVID-19 and precautionary measures. The purpose of this conference meeting was to address non-compliance at the facility after being issued 14 Type A citations and 12 substantiated complaint allegations since 2018. Present in the meeting was CCLD staff, including Regional Manager Alycia Berryman, Licensing Program Manager Laura Munoz, Licensing Program Analyst Kevin Mknelly, and Licensing Program Analyst Michael Hood, and facility staff, including the Vice President of Operations Laura Fischer, Administrator/Executive Director Christine Salle, District Director of Operations Rhonda Dolcater, District Director of Clinical Services Lori Fries, Compliance Specialist Jina Amstutz, and Attorney Joel S. Goldman. The conference process was explained during this meeting.

Issues discussed during this meeting were:
· An overview of non-compliance at the facility regarding 14 Type A citations, 12 substantiated complaint allegations, and multiple civil penalties since 2018
· Repeat violations regarding medication errors - medication management
· Shortages of trained and qualified staff - basic services and staffing

The facility has stated that they will do the following to achieve continued and substantial compliance:
· Conduct regular audits of medications
· Maintain resident records and utilize staff according to residents' needs
· Maintain staff records to keep staff training updated
· Created Compliance Director position to conduct more frequent, ongoing oversight of compliance

An exit interview was conducted and a copy of this report will be provided to the facility via email. A copy must be signed and returned to CCLD.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (323) 485-4915
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: 916-531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021
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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