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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005860
Report Date: 05/17/2023
Date Signed: 05/17/2023 11:08:17 AM

Document Has Been Signed on 05/17/2023 11:08 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, 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: 5DATE:
05/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:CaregiverTIME COMPLETED:
11:15 AM
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On 05/17/23, Licensing Program Analyst (LPA) Kevin Mknelly, conducted a case management visit for a health and safety check. Caregiver notified newly designated Administrator, Karen Lim, who arrived to assist with the visit.

The home was inspected and found to be clean and in good repair. There is required food supplies. Two caregivers are present and appear to meet the needs of residents.

LPA requested: Letter of Administrator designation from the licensee as well as LIC 500's for the three(3) homes the Administrator is currently working at. Documents to be submitted by Monday, 5/22/23.

LPA and Administrator agreed that Administrator will conduct an audit of all resident and staff records. Administrator will present a plan to LPA by 5/25/23 with findings of the audit as well as a plan for maintaining records and training.

Administrator will develop a plan for staff performance reviews to facilitate quality assurance and identify training needs.


As a result of today’s inspection, no deficiencies were noted.

Report reviewed. Copy of report provided
SUPERVISORS NAME: Maribeth Senty
LICENSING EVALUATOR NAME: Kevin Mknelly
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2023
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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