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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 502700235
Report Date: 10/18/2023
Date Signed: 10/18/2023 03:32:05 PM


Document Has Been Signed on 10/18/2023 03:32 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
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:EL RIO MEMORY CARE COMMUNITYFACILITY NUMBER:
502700235
ADMINISTRATOR:KENT E MULKEYFACILITY TYPE:
740
ADDRESS:2828 HEALTHCARE WAYTELEPHONE:
(209) 543-3805
CITY:MODESTOSTATE: CAZIP CODE:
95356
CAPACITY:72CENSUS: 57DATE:
10/18/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:17 PM
MET WITH:Kent MulkeyTIME COMPLETED:
03:45 PM
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On 10/08/2023, Licensing Program Analyst (LPA) Kimberly Viarella made an unannounced visit to this facility to conduct interviews as a part of a complaint investigation. The LPA identified herself, the reason for the visit and asked to speak with the Designated Facility Administrator. LPA met with Executive Director, Kent Mulkey. A brief interview followed.

The LPA observed the residents eating lunch in 2 separate dining rooms. LPA observed that one resident would scratch for 10 -15 seconds, stop for 5 seconds, then begin scratching again. The LPA witnessed this cycle repeat 4 times. The LPA brought it to the attention of the Regional Nurse who confirmed that that a prescription for scabies medication was received on 10/17/23.

During the course of the investigation, this LPA learned that 31 additional residents have been suspected of, and treated for, scabies. This information should have been reported to Community Care Licensing as well as the Department of Public Health.

Due to time constraints, this case management and the deficiencies associated with today's visit, will be completed at a later date.

Exit interview.

SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Kimberly ViarellaTELEPHONE: (916) 809-5764
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2023
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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