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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005860
Report Date: 03/15/2023
Date Signed: 03/15/2023 01:35:34 PM

Document Has Been Signed on 03/15/2023 01:35 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, 2525 NATOMAS PARK DR STE 270
SACRAMENTO, CA 95833
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: 4DATE:
03/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Maria So, Administrator TIME COMPLETED:
01:35 PM
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 Licensing Program Analyst (LPA) Sabrina Calzada and Ombudsman, Ron Carrera, arrived unannounced and met with Nina Lemence and Amalia Eslao, caregivers. Administrator, Maria, arrived at 1:20 pm. LPA explained purpose of inspection. Caregivers confirmed there are (4) residents present and (2) residents are receiving hospice services.

LPA and Ombudsman toured the facility and observed all (4) residents to be in their rooms. LPA observed sufficient food and paper supplies to be on site. LPA observed the facility to be clean, in good repair and odor free. LPA observed (2) vacant resident rooms.

Administrator, Maria, stated there is an on-call Administrator currently, and she plans to hire a permanent Administrator on 3/20/23. Administrator to provide information of new Administrator.

There are no citations being issued today.

Exit interview. Copy of report left with Administrator.
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Sabrina Calzada
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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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