<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347004255
Report Date: 03/06/2024
Date Signed: 03/06/2024 11:20:30 AM


Document Has Been Signed on 03/06/2024 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:LIVING HEALTHY HOME CAREFACILITY NUMBER:
347004255
ADMINISTRATOR:TITUS POPAFACILITY TYPE:
740
ADDRESS:7540 SOQUEL WAYTELEPHONE:
(916) 628-4412
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:6CENSUS: 5DATE:
03/06/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Titus Popa, Administrator TIME COMPLETED:
11:20 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA)Sabrina Calzada arrived unannounced to conduct a required annual and met with Titus Popa, Administrator, and explained purpose of inspection. Also present was caregiver, Galina Bonta. LPA observed (1) resident in the common area and (4) residents in their rooms at the start of the inspection. The facility is licensed for (6) non-ambulatory residents and has a hospice waiver for (3). Currently, there are (2) residents on hospice.

LPA and Administrator toured the interior and exterior of the facility including the common areas, (4) private resident bedrooms (1) shared resident bedroom, (3) resident bathrooms, kitchen, office, staff room and laundry/garage 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 and hand-washing posters. LPA observed sufficient 2+day perishable and 7+day non-perishable supply of food, and sharps to be locked in the kitchen. Medications are locked in a nearby cabinet and toxins are locked in the laundry room. Inside temperature measured 74*F and hot water measured 105*F in the kitchen. There are sufficient towels, linens, paper products and PPE. First Aid kit is complete. Fire extinguisher was last serviced on 1/5/2024 and smoke/monoxide alarms are in working order. There are activities/games on site with sufficient indoor/outdoor space. There is an outdoor walking track and covered patio with seating. There are (2) unlocked exit gates. (3) resident files were reviewed and found to be organized and contain current documentation, including care plans/physician's reports. Medications were reviewed for (2) residents- orders matched medications being administered and documentation is complete. (7) staff files were reviewed and found to be complete, organized and contain current training documentation, including First Aid/CPR. RCFE Administrator certificates are current. All staff are cleared and associated to the facility. Infection Control Plan was reviewed/approved. Emergency Disaster Plan was reviewed and is posted.
Obtained copy of current liability insurance and LIC308. LIC500 to be provided by 3/13/24.

There were no deficiencies observed. Exit interview. Copy of report provided.
SUPERVISOR'S NAME: Maribeth SentyTELEPHONE: (916) 263-4813
LICENSING EVALUATOR NAME: Sabrina CalzadaTELEPHONE: (510) 829-2133
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1