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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005209
Report Date: 03/03/2021
Date Signed: 03/03/2021 05:26:32 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:BEST LIFE HOME CARE, LLC.FACILITY NUMBER:
347005209
ADMINISTRATOR:BUTTS, CHRISFACILITY TYPE:
740
ADDRESS:7205 BARANGA DRIVETELEPHONE:
(916) 726-2292
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95621
CAPACITY:6CENSUS: 6DATE:
03/03/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Chris Butts, AdministratorTIME COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs) Kevin Mknelly and Michael Hood were joined by a California Department of Public Health (CDPH) nurse, on a Web Ex tele-visit with administrator Chris Butts. Today's visit was conducted by telephone due to COVID-19 and precautionary measures. The purpose of today's inspection was to conduct a health and safety check and to provide public health technical assistance.

LPA Mknelly had conducted Covid 19 welfare calls in October 2020 and February 2021 where various department guidelines were not adhered to. LPAs and CDPH RN conducted a tele-inspection of some of the home. The facility appeared clean and in good repair.

The following was reviewed with the Administrator: continued mandated use of face coverings for all caregivers, cleaning and sanitizing procedures, physical distancing for residents, hand washing procedures, daily symptom screening and recording for all staff and residents, and continued surveillance testing of staff- 25 % of staff every seven days. Administrator stated understanding of the requirements and intends to follow department guidelines in place. Administrator agrees to submit to CCL a copy of the facility’s daily symptom screenings and weekly surveillance testing by 3/18/2021.

Additionally, LPAs have provided internet links for testing locations, disinfecting product guidelines, PIN 20-46 enforcement measures and CCL power-point presentation for post vaccines precautions.

To date, this facility has had no known or suspected Covid-19 positive staff or residents. As a result of today’s inspection, no deficiencies were cited.

A copy of this report has been emailed to the facility and the Administrator was advised that a signed copy of the report shall be submitted to CCLD. Exit interview conducted.
SUPERVISOR'S NAME: Anthony PerezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Michael HoodTELEPHONE: (916) 531-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2021
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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