<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500306146
Report Date: 03/05/2021
Date Signed: 03/05/2021 03:33:25 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:LAS PALMAS ESTATESFACILITY NUMBER:
500306146
ADMINISTRATOR:MILLER, KREGGFACILITY TYPE:
740
ADDRESS:1617 COLORADOTELEPHONE:
(209) 632-8841
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:89CENSUS: 79DATE:
03/05/2021
TYPE OF VISIT:Case Management - Health ChecksUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator Kregg MillerTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
A virtual case management visit was done by zoom on 3/5/21. The purpose of the meeting is to discuss progress towards the facilities continuing COVID compliance. Present in the meeting was Licensing Program Manager Stephenie Doub, Licensing Program Analyst Jason Lund, Maryesther Sanchez, MSN, RN, PHN III Stanislaus County Public Health and Jill Peterson Stanislaus County Public Health and the Licensee/Administrator Kregg Miller.

There are 79 residents currently at the facility.

Issues discussed during the meeting were:

- Supplies

- Staffing

- Safety

- Oversight

- Continue monitoring of the facility/Testing of staff for COVID

- Submitting a line list daily to the Local Health Department and to the Department.

An exit interview was conducted with Kregg Miller via telephone and a copy of this report was provided via email and an electronic email read receipt confirms receiving these documents.

SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1