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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 392700997
Report Date: 09/10/2022
Date Signed: 09/10/2022 02:39:08 PM


Document Has Been Signed on 09/10/2022 02:39 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:CAMLU ASSISTED LIVINGFACILITY NUMBER:
392700997
ADMINISTRATOR:DIANE WRIGHTFACILITY TYPE:
740
ADDRESS:6037 N. PERSHING AVENUETELEPHONE:
(209) 951-2030
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:160CENSUS: 51DATE:
09/10/2022
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Shalini PeterTIME COMPLETED:
03:00 PM
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On 09/10/2022, Licensing Program Analyst (LPA) Arielle Pascua arrived at the facility unannounced to conduct health and safety checks. LPA Pascua met with Medication Technician (MT), Shalini Peter and explained the purpose of today’s visit. Shortly after, LPA Pascua met with Medication Technician (MT), Jennifer Armendariz

The purpose of this visit was to follow up on concerns regarding a high temperature in the facility. It was learned that the A/C has not been sufficiently cooling the facility. LPA Pascua interviewed the Facility Designated Administrator, Diane Wright on the phone. It was learned that the facility has been waiting on A/C units which have been backlogged for a couple of months. FDA, Wright stated that she will follow up on Monday to see if the A/C units have arrived.

There are hydration tables on the first and second floor.


The facility has purchased Portable Air Conditioners for every resident and have been installed in their respective rooms. Staff have been conducting wellness checks on residents every two hours or as needed.
Additionally, the facility has 3 large fans at the end of each floor's hallways. There are two additional large fans in the front lobby, and dining area.

Current temperature on the 1st floor hallways and resident rooms were measured to be 79-83 degrees.
The temperature in the hallways and resident rooms on the upper level was measured to be between 78-83 degrees.

Residents were observed to be comfortable and content with the temperature at this time.

No deficiencies are being cited as a result of today's visit. An exit interview was conducted and a copy of this report was given to Medication Technician, Jennifer Armendariz
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Arielle PascuaTELEPHONE: 916-263-4700
LICENSING EVALUATOR SIGNATURE:
DATE: 09/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/10/2022
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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