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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005209
Report Date: 08/17/2023
Date Signed: 09/29/2023 08:42:27 AM


Document Has Been Signed on 09/29/2023 08:42 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: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: 5DATE:
08/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Chris Butts and Helen TanTIME COMPLETED:
05:00 PM
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LPA Tryon visited the facility to do an annual review. LPA was greeted by licensees Helen Tan and Chris Butts.
LPA toured the house including common areas, kitchen, food storage, bedrooms, bathrooms, hallways. The facility is clean and in good repair, nicely furnished. Smoke detectors and carbon monoxide detectors are installed, fire extinguisher present. Food supplies are appropriate to meet the requirement of 2 days perishable and 7 days non-perishable.
Medications are centrally stored and locked. LPA reviewed 2 residents files which included required information. Staff have appropriate classes, clearances, etc.

LPA reviewed the CARE Tool with licensees.

At this time, the home appears to be in substantial compliance with the regulations. No deficiencies were cited at this visit. Exit interview conducted.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4832
LICENSING EVALUATOR NAME: Todd TryonTELEPHONE: (916) 263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2023
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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