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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
455002550
Report Date:
07/16/2024
Date Signed:
07/16/2024 11:39:29 AM
Document Has Been Signed on
07/16/2024 11:39 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
,
9835 GOETHE ROAD, SUITE 100
SACRAMENTO
,
CA
95827
FACILITY NAME:
SERENITY GARDENS
FACILITY NUMBER:
455002550
ADMINISTRATOR:
CAIN, BETTY
FACILITY TYPE:
740
ADDRESS:
1233 WILLIS STREET
TELEPHONE:
(530) 605-4033
CITY:
REDDING
STATE:
CA
ZIP CODE:
96001
CAPACITY:
30
CENSUS:
24
DATE:
07/16/2024
TYPE OF VISIT:
Case Management - Health Checks
UNANNOUNCED
TIME BEGAN:
10:00 AM
MET WITH:
Betty Cain Licensee
TIME COMPLETED:
11:45 AM
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On 7-16-24 at 10:00AM Licensing Program Analyst LPA Sarah Benson arrived at the facility to perform a health and safety check of residents in care regarding flooding of the facility. LPA Benson met with Licensee Betty Cain.
Licensee Betty Cain and LPA Benson toured the facility together. LPA Benson observed residents throughout the front of the facility relaxing in recliners and performing daily activities. Administrator reported contacting all residents responsible persons.
Licensee stated six resident rooms were affected by the water. Licensee reported the affected resident room floors have been tested with a moisture meter and are drying out nicely. Licensee reports the residents have access to their rooms at this time. Licensee reports that one resident was moved to another room after consulting with the residents family. The licensee states the work that needs to be done in the resident rooms can be done during the day while the residents are busy in the front half of the facility with daily activities.
The licensee states the facility is waiting for the insurance company claim before the final inspection will be performed. Administrator will notify LPA when repairs are complete and the final inspection is complete.
SUPERVISOR'S NAME:
Lauren Crocker
TELEPHONE:
(916) 261-4966
LICENSING EVALUATOR NAME:
Sarah Benson
TELEPHONE:
530-895-5033
LICENSING EVALUATOR SIGNATURE:
DATE:
07/16/2024
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/16/2024
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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