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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700165
Report Date: 07/26/2023
Date Signed: 07/26/2023 02:56:48 PM

Document Has Been Signed on 07/26/2023 02:56 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:PRESTIGE CARE CENTER LLCFACILITY NUMBER:
502700165
ADMINISTRATOR:MCNEAL, TANISHAFACILITY TYPE:
735
ADDRESS:474 SUNDAY DRTELEPHONE:
(209) 443-7707
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY: 6CENSUS: 4DATE:
07/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Administrator Massi McNealTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Jason Lund arrived unannounced to conduct an annual/required visit. LPA Lund met with Administrator Massi McNeal and explained the reason for the visit. Census: 4

LPA Lund & Administrator Massi McNeal toured/inspected the facility ensure compliance with Title 22. There are three bedrooms, two of which are private, and one is double occupancy. LPA observed the rooms to be properly furnished, in good condition with appropriate lighting and furnishings. The bathrooms were in sanitary condition, properly maintained and the hot water temperature to be 109 degrees.

LPA checked the kitchen area for ability to prepare and store food. Care home has (2) two- day perishable and (7) seven-day non-perishable food supply on hand. LPA observed knives and toxins to be locked away and inaccessible to residents. LPA inspected the backyard and perimeter of the care home and observed all storage sheds to be locked and secured. There appeared to be no safety hazards to residents. Smoke detectors are hard wired and operational in care home. Home also has a carbon monoxide detector.

LPA checked medication storage and found medication to be locked away and inaccessible to residents in care. LPA reviewed 2 clients file and 2 staff files, and all documentation was in each file.

No deficiencies cited exit interview held and copy of report left.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2023
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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