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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005860
Report Date: 08/16/2021
Date Signed: 08/16/2021 04:15:54 PM

Document Has Been Signed on 08/16/2021 04:15 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
CCLD Regional Office, 520 COHASSET RD., STE. 170
CHICO, CA 95926
FACILITY NAME:MCGREGOR HOME GARFIELDFACILITY NUMBER:
347005860
ADMINISTRATOR:MARIA KATRINA SOFACILITY TYPE:
740
ADDRESS:3136 GARFIELD AVENUETELEPHONE:
(916) 692-5886
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 6CENSUS: 6DATE:
08/16/2021
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Helen Yee, Co-Administrator TIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) Calzada arrived unannounced to conduct a required annual inspection and conduct a collateral visit to interview Co-Administrator regarding an open complaint at a related facility, 347005340.

LPA met with Amalia Eslao, caregiver, who contacted Co-Administrator by phone to advise of inspection. LPA explained purpose of inspection to caregiver. Co-Administrator, Maria So, arrived at the facility at approximately 2:40 pm. Prior to initiating today's inspection, LPA completed required COVID-19 testing protocols, contacted the facility to confirm there are currently no positive Covid-19 diagnoses, completed a daily self-screening questionnaire for symptoms of COVID-19 infection to affirm no COVID-19 related symptoms Additionally, LPA was screened per Covid-19 precautionary measures upon entering the community. LPA ensured she applied hand sanitizer before entering the facility and the following Personal Protective Equipment (PPE) was worn: surgical Mask. Co-Administrator Helen Yee arrived at approximately 3:00 pm.

During today's collateral inspection, LPA interviewed Helen Yee, Co-Administrator, regarding the allegations in open complaints # 25-AS-20210510100407 and # 25-AS-20210519111407.

There are no deficiencies being cited in this report.

Exit interview. Copy of report left at facility.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2021
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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