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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700721
Report Date: 01/20/2023
Date Signed: 01/20/2023 02:12:30 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/20/2023 02:12 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:DIAMOND CARE INC.FACILITY NUMBER:
392700721
ADMINISTRATOR:CARIE SONODGRASSFACILITY TYPE:
740
ADDRESS:7910 BRIGHT RDTELEPHONE:
(209) 914-2859
CITY:FRENCH CAMPSTATE: CAZIP CODE:
95231
CAPACITY:16CENSUS: DATE:
01/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Zachary Murphy-DuncanTIME COMPLETED:
02:30 PM
NARRATIVE
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On 1/20/23 at approximately 10:30am Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required one year annual. LPA Jensen met with general manager Zachary Murphy-Duncan and explained the purpose of today's visit.

The facility has two main buildings plus a smaller detached single room structure. There is a swimming pool on the grounds that is fenced and locked and a pond on the grounds that is covered with fencing materials. The grounds were observed to be well maintained and free of debris. There is a large outdoor space for activities and patio furniture available for resident use. The grounds are gated all around. Upon arrival at the facility LPA Jensen was greeted by a care provider who met LPA at the gate, verified her identity and took a temperature reading. LPA Jensen was then escorted to the side of the house where she was provided a face shield and gown and instructed to wash her hands before entering. The facility was observed to be sanitary and free of odor. All sharp objects and toxins were observed to be locked and inaccessible to residents in care. The facility was observed to have a 2 day supply of perishable food and a 7 day supply of non perishable food on hand. A menu was posted in a prominent place in the kitchen. The refrigerator temperature at site 100 was observed to be at approximately 68 degrees. As a result of the refrigerator temperature reading above the required regulatory temperature, facility staff discarded all perishable food in that refrigerator. There was still sufficient food supply on hand to meet regulatory requirements.

LPA Jensen toured the resident bedrooms and observed each to be equipped with a dresser, chair, night stand and lamp. LPA Jensen observed the bathrooms to be equipped with grab bars at the toilet and shower. There were non-slip mats observed in the showers.

Continued on LIC 809C....
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: DIAMOND CARE INC.
FACILITY NUMBER: 392700721
VISIT DATE: 01/20/2023
NARRATIVE
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LPA Jensen tested the smoke detectors and carbon monoxide detectors and found them to be in compliance. The fire extinguishers were observed to be incompliance. The facility conducts fire drills bi-annually and the last fire drill was conducted in October of 2022. There is emergency lighting, food, and a 30 day supply of PPE on hand. The facility maintains at least one first aid kit in each building that is complete with scissors, tweezers, thermometer and manual. LPA Jensen observed the emergency disaster plan to be posted and in compliance. The facility has back up generators for use in case of an emergency.

LPA Jensen observed all medications to be locked and inaccessible to residents in care. LPA Jensen reviewed a random resident file and staff file and observed them to be complete. The facility has just implemented a log for documenting the effectiveness of PRNs.

LPA Jensen observed the liability insurance to be current and was given a copy for the master file. All staff present at the facility were observed to have criminal background clearance and were associated to the facility. The licensing fees were determined to be in arrears.

LPA Jensen observed all required signage in the facility including but not limited to resident rights, resident council, Ombudsman contact information, "Say Something, See Something" and COVID infection mitigation.

Citations are being issued from the California Code of Regulations. Failure to correct deficiencies may result in the assessment of civil penalties.

An exit interview was conducted a copy of this report was provided.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/20/2023 02:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833


FACILITY NAME: DIAMOND CARE INC.
FACILITY NUMBER: 392700721

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2023
Section Cited

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General Food Service Requirements
The following food service requirements shall apply:...refrigerators of adequate size shall maintain a maximum temperature of 40 degrees F (4 degrees C). They shall be kept clean and food stored to enable adequate air circulation to maintain the above temperatures. This requirement was not as evidenced by:
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Facility staff discarded all perishable food and ordered replacement food during the course of the site visit. The unit will under go maintenance and licensee will submit proof of maintenance via email by POC due date to maja.jensen@dss.ca.gov
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Based on LPA Jensen's observation of the refrigerator in site 100 being 68 degrees. This poses a potential risk to teh health, safety and personal rights of residents in care.
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Type B
01/27/2023
Section Cited

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Licensing Fees
The failure of an applicant for licensure or a licensee to pay all applicable and accrued fees and civil penalties shall constitute grounds for denial or forfeiture of a license. This requirement was not met as evidenced by:
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Licensee agrees to pay fees owed within 24 hours.
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Based on LPA Jensen's verification in the Licensing Infromation System annual feels have not been paid since initial licensure. This poses a potential risk to the health, safety and personal rights of residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Liza KingTELEPHONE: (916) 263-4752
LICENSING EVALUATOR NAME: Maja JensenTELEPHONE: 916-639-5584
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3