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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005209
Report Date: 08/07/2024
Date Signed: 08/07/2024 01:57:19 PM


Document Has Been Signed on 08/07/2024 01:57 PM - 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: 6DATE:
08/07/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Administrator- Helen Tan & Chris ButtsTIME COMPLETED:
02:00 PM
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On 08/07/24 Licensing Program Analyst (LPA) Cheyenne Ratajczak arrived at the facility unannounced to conduct a required 1 year annual inspection utilizing the care tool. LPA met with Administrators Helen Tan and Chris Butts and explained the purpose of the visit.

Administrator and LPA conducted a tour of the interior and exterior of the facility. Areas toured included but not limited to four (4) resident bedrooms, two (2) bathrooms, laundry room, common areas and backyard.
LPA observed required furniture, and lighting throughout the residents' bedrooms and facility. LPA observed food supplies of non-perishables for a minimum of seven (7) days and perishable foods for a minimum of two (2) days. Toxins and cleaning supplies are locked and inaccessible to residents in care. Hot water temperature was measured at 110.6 degrees Fahrenheit at the kitchen sink, which is within the required range of 105 to 120 degrees. First aid kit was completed. LPA observed fire detectors and carbon monoxide detectors to be operable. LPA observed the fire extinguisher, located in the hallway, which was last inspected on 07/12/24 LPA observed required Licensing posters posted throughout the facility. Medications are centrally stored and locked. LPA conducted a file review of two (2) personnel and four (4) residents records.

No deficiencies are being cited during today's inspection.

Exit interview conducted and copy of the report was left at the facility.

SUPERVISOR'S NAME: Laura MunozTELEPHONE: (916) 263-4743
LICENSING EVALUATOR NAME: Cheyenne RatajczakTELEPHONE: (916) 969-7879
LICENSING EVALUATOR SIGNATURE:
DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/07/2024
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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