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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803710
Report Date: 12/19/2022
Date Signed: 12/19/2022 10:58:12 AM


Document Has Been Signed on 12/19/2022 10:58 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: 83DATE:
12/19/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Administrator, Richard RemigioTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Paramount House Senior Living for the purpose of conducting a Plan of Correction (POC) inspection. LPA was greeted at the door by, Administrator, Richard Remigio, and was granted access into the facility.

During the POC inspection, LPA and Administrator discussed the Plan of Correction (POC) as well as retaining a weekly staff schedule to send to the LPA for 90 days. This plan will also include an outside agency to cover staffing if the facility is short staffed. In addition, LPA discussed Reporting Requirements with the Administrator and disclosing concerns/incidents with the Responsible Parties as well as CCL. Furthermore, LPA and Administrator discussed Incidental Medical and Dental Care and ensuring that residents are receiving medication in a timely manner and following all medication assessment orders from the Primary Care Physician/Doctor.

No deficiencies were observed or cited during today's Plan of Correction (POC) inspection. Exit interview was conducted and a copy of this report was emailed to the facility Administrator due to printer issues.
SUPERVISOR'S NAME: Hope DeBenedettiTELEPHONE: (707) 588-5029
LICENSING EVALUATOR NAME: Farhaan SarangiTELEPHONE: 707-588-5034
LICENSING EVALUATOR SIGNATURE:
DATE: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/19/2022
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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