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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803710
Report Date: 09/02/2022
Date Signed: 09/02/2022 11:20:29 AM


Document Has Been Signed on 09/02/2022 11:20 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:PARAMOUNT HOUSE SENIOR LIVINGFACILITY NUMBER:
486803710
ADMINISTRATOR:REMIGIO, RICHARDFACILITY TYPE:
740
ADDRESS:2061 PEABODY RDTELEPHONE:
(707) 455-0300
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:95CENSUS: DATE:
09/02/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Richard RemigioTIME COMPLETED:
11:30 AM
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At approximately 9:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced to conduct a case management visit in regards to two incidents reported by the facility. LPA met with Executive Director Richard Remigio, interviewed staff and reviewed records.
Incident #1:
Facility received information from an anonymous source that stated the Director of Dining services was yelling at staff and residents. Upon receiving the information an investigation was conducted by the Executive Director. Multiple residents, who are known to frequently spend time near the kitchen, were interviewed. One resident mentioned they heard a loud voice coming from the kitchen, but it was not directed towards residents and the resident could not recall what was said. LPA toured the kitchen and attempted to speak with the kitchen staff. Due to the constant noise of exhaust fans and other noises, LPA could not hear what was said. LPA observed that kitchen staff might have to raise their voice to be heard over the other noises. Executive Director will continue to monitor the situation.
Incident #2:
An SOC 341 was submitted to Licensing by the facility in regards to a domestic dispute between two residents who are married and live in the same apartment. LPA interviewed staff and reviewed records. Neither resident requires supervision and they are their own responsible parties. Facility reported the situation as required. LPA received copies of documents.

No citations issued.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christopher ArnholdTELEPHONE: (707) 588-5084
LICENSING EVALUATOR SIGNATURE:
DATE: 09/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/02/2022
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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