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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700551
Report Date: 08/04/2021
Date Signed: 08/04/2021 10:37:13 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:CAMLU ASSISTED LIVINGFACILITY NUMBER:
392700551
ADMINISTRATOR:WHITTED, ALMAFACILITY TYPE:
740
ADDRESS:6037 N PERSHING AVETELEPHONE:
(209) 951-2030
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:96CENSUS: 63DATE:
08/04/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Alma WhittedTIME COMPLETED:
10:45 AM
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On 08/4/2021 at 8:45am, Licensing Program Analyst (LPA) Ashley Boothe, arrived unannounced to conduct a conduct a Health and Safety visit based on a report that the air conditioning system in the facility is inoperable. LPA met with Administrator Alma Whitted and explained the purpose of today’s inspection. Prior to today's visit LPA spoke with Administrator regarding facility risk assessment questions who confirmed no staff or clients have experienced symptoms within the last 10 days.. Current Census is 63.

The purpose of the visit was to check on the temperature in the facility. LPA measured the temperature to be at 74*F in the common areas, 73* in the dining area , 79* in a hallway and 74* in offices. 25 of 84 resident rooms within regulatory range. The facility has purchased 70 portable air conditioning units, one for each room that resident have access to control and several large portable cooling units until the AC system is repaired/replaced. Temperatures were within regulatory range of 68*F to 85*F. The Administrator has created a temperature log and purchased a thermometer to read air temperature. Administrator stated since last inspection the temperature is being taken randomly throughout the facility and recorded and stored with facility records and no complaints from residents or staff have about the heat. LPA observed records to document no temperatures outside of regulatory range.

Per the California Code of Regulations, Title 22, Division 6, no deficiencies observed or cited. Exit interview held, copy of report given.

SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Ashley BootheTELEPHONE: (916) 708-7751
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
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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