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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 500306146
Report Date: 07/06/2023
Date Signed: 07/06/2023 05:32:42 PM


Document Has Been Signed on 07/06/2023 05:32 PM - 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, 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: 82DATE:
07/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Le Ann Blocker Resident CoordinatorTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an annual/required inspection. LPA Lund met Le Ann Blocker Resident Coordinator and explained the purpose of the visit.

LPA Lund and Le Ann Blocker Resident Coordinator toured/inspected the physical plant including but not limited to kitchen, bedrooms, bathrooms, living and dining room area. LPA observed sufficient furniture and lighting throughout the facility. LPA observed sufficient seven- day non-perishable and two- day perishable food supplies. Hot water temperature was measured at 113.5 degrees Fahrenheit in resident bathroom sink, which is within the required range of 105 to 120 degrees. Fire extinguishers and smoke detectors are current and in compliance with fire safety. Carbon dioxide monitor present. LPA observed centrally stored medications locked inside the medication charts. First aid kit was checked and is complete.

LPA Lund reviewed eight resident and four staff files, including criminal record clearances. All staff today are Fingerprint cleared and associated to the facility.

No deficiencies were cited during this inspection. Exit interview held and a report given at the conclusion of the visit.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:
DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/06/2023
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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