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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347003712
Report Date: 10/01/2021
Date Signed: 10/19/2021 01:29:27 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 SYLVAN RANCHFACILITY NUMBER:
347003712
ADMINISTRATOR:ALEJANDRA C SALLEEFACILITY TYPE:
740
ADDRESS:7375 STOCK RANCH RDTELEPHONE:
(916) 729-2722
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:56CENSUS: 16DATE:
10/01/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Christine Sallee, AdministratorTIME COMPLETED:
01:45 PM
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A follow-up meeting to 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 the facility's compliance following a non-compliance conference conducted on 7/15/2021 due to receiving 4 Type A citations and 12 substantiated complaint allegations since 2018. Present in the meeting was CCLD staff, including Licensing Program Manager Rayna Bryson and Licensing Program Analyst Michael Hood, and facility staff, including the Administrator/Executive Director Christine Sallee, Vice President of Operations Laura Fischer and Zachary Butcher, District Director of Operations Laura Eckert and Rhonda Dolcater, Compliance Specialist Jina Amstutz, and Attorney Joel S. Goldman. The conference process was explained during this meeting.

Topics discussed during this meeting were:
· Facility's ongoing compliance since non-compliance conference conducted on 7/15/2021
· Actions taken to address when residents experience a fall
· Actions taken to address staffing and staff training
· Actions taken to address medication errors

The facility is doing the following to achieve continued and substantial compliance:
· Facility has plan to address the care needs for residents who are a fall risk, including accurate resident assessments, timely reporting of falls, and preventive measures to reduce fall incidents
· Facility is conducting regular training for staff, including medication technicians
· Facility is performing regular audits of residents' medications

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: 10/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021
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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