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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
397004985
Report Date:
02/28/2025
Date Signed:
03/04/2025 10:47:30 AM
COMPREHENSIVE INSPECTION
Document Has Been Signed on
03/04/2025 10:47 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 SOUTH ASC
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
CHOICE MANOR 2 ARF
FACILITY NUMBER:
397004985
ADMINISTRATOR/
DIRECTOR:
LORETTA LIVINGSTON-ANTHONY
FACILITY TYPE:
735
ADDRESS:
7270 SOUTHFIELD WAY
TELEPHONE:
(209) 472-9904
CITY:
STOCKTON
STATE:
CA
ZIP CODE:
95207
CAPACITY:
6
CENSUS:
4
DATE:
02/28/2025
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:
Loretta Livingston-Anthony
TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA) Albert Johnson made an unannounced visit on to complete the Annual Required Visit.
LPA observed bedrooms to be properly furnished with appropriate bedding and lighting. The bathroom was in sanitary condition and properly maintained. The hot water temperatures measured in bathroom and kitchen was observed to be within the acceptable range of 105 to 120 degrees F.
LPA checked the kitchen area for the ability to prepare and store food. LPA observed there to be a sufficient amount of perishable and nonperishable food supply on hand. LPA observed knives and toxins to be locked away and inaccessible to clients. LPA observed the backyard of the facility to be free of clutter and debris and there appeared to be no potential safety hazards to the clients.
Smoke detectors are hard wired and operational and care home also has a carbon monoxide detector. Fire extinguishers and first aid kit are maintained and ready for emergency use. LPA checked medication storage and found medication to be locked away and inaccessible to clients. LPA reviewed client medication and are accurate based on current client medication lists. LPA reviewed four client files and observed all required documentation to be in place.
No deficiencies were cited during today visit.
Exit interview conducted and a copy of the report was left at the facility.
SUPERVISORS NAME
:
Lisa Rios
LICENSING EVALUATOR NAME
:
Albert Johnson
LICENSING EVALUATOR SIGNATURE
:
DATE:
02/28/2025
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
02/28/2025
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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