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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496830756
Report Date: 10/12/2021
Date Signed: 12/22/2021 09:17:28 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:MUIRWOODS MEMORY CAREFACILITY NUMBER:
496830756
ADMINISTRATOR:RODRIGUEZ, BRANDEEFACILITY TYPE:
740
ADDRESS:750 NORTH MCDOWELL BLVDTELEPHONE:
(707) 775-4330
CITY:PETALUMASTATE: CAZIP CODE:
94954
CAPACITY:80CENSUS: 44DATE:
10/12/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Regional Director of Operations of Northern CA Courtney Hill & Interim Ex. Director Tracy Freudendahl TIME COMPLETED:
10:51 AM
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An informal meeting was conducted today in the Rohnert Park Regional Office via Microsoft Teams due to Covid19 precautions. Present in the meeting were, Licensing Program Manager, Bethany Moellers, Licensing Program Manager, Kimberly Mota, Licensing Program Analyst, Shannan Hansen, Licensing Program Analyst, Carla Fernandez-Goes, and for the facility Regional Director of Operations of Northern CA Courtney Hill & Interim Ex. Director Tracy Freudendahl .

The purpose of the informal office meeting was to discuss ongoing concerns that have been identified with the operation of this facility.

The following was discussed during the office meeting:
  • Staffing Concerns - A full recruiter for Muirwoods has been implemented and in the last month additional care givers and med techs have been hired. They are continuing to use an agency as well. They continue to recruit.
  • All shifts are looking for employees, but are fully staffed by using agency to supplement. They are accepting new residents. Ed Tracy Freudendahl stated in August due to COVID outbreak they had issues with hiring but that has subsided and are continuing to hire.
  • SIRs of incidence's between residents was discussed
  • Tracy - Has been at the facility overseeing for a few weeks she has not seen any situation where she has not been able to find a staff for a resident.
  • How facility is going to train. Tracy - Retraining with all medical technicians was conducted for consistency.
  • Executive Director Brandee Rodriguez is to return to the facility next week 10/18/2021 from leave

  • No deficiencies were cited during today's visit
SUPERVISOR'S NAME: Kimberley MotaTELEPHONE: (707) 588-5051
LICENSING EVALUATOR NAME: Shannan HansenTELEPHONE: 707-588-1410
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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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