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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507000962
Report Date: 02/11/2025
Date Signed: 02/11/2025 01:31:36 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/11/2025 01:31 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:LIFESPRING SENIOR CAMPUS, A WELLNESS COMMUNITYFACILITY NUMBER:
507000962
ADMINISTRATOR/
DIRECTOR:
CYNTHIA MCDANIELFACILITY TYPE:
740
ADDRESS:936 GEER ROADTELEPHONE:
(209) 634-7764
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY: 40TOTAL ENROLLED CHILDREN: 0CENSUS: 18DATE:
02/11/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Cynthia McDaniel, AdministratorTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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On 02/11/25, Licensing Program Analyst (LPA) Renee Campbell arrived to the facility unannounced regarding their yearly inspection. LPA Campbell met with Cynthia McDaniel, Administrator and explained the purpose of the visit. The facility is a series of four separate one story buildings, licensed to serve clients age 60 and older. There is a fire clearance for 29 non-ambulatory residents and a hospice waiver has been granted for 2.

Upon entry, LPA Campbell observed two clients eating breakfast before going with the administrator to the main office. In the main office building and the Symphony building, See Something Say Something posters and ombudsman information posters were observed on the walls. Rooms were observed to have the appropriate furniture (bed, night stand, lamps) along with a closet. Rooms had their own bathrooms or were directly next to a bathroom in the hallway.

The refrigerator and food pantry were observed to have sufficient seven-day non-perishable and two-day perishable food supplies. Client's with special dietary needs were posted in the kitchen. The food pantry is in the basement of the facility with the washer and dryer in a separate area. Cleaning toxins were also in the basement behind a locked door. The hot water temperature was measured in the bathroom at 105 degrees Fahrenheit (F). Fire extinguishers and the smoke alarm are in good repair as confirmed by the Turlock FIre Department and the sprinkler system was tested as well. The fire extinguisher was last inspected on 08/21/2024. The thermostat was set at 74. The carbon monoxide alarm was tested and found to be functioning.

A fire drill log for the facility was observed. Monthly drills for fire, wind and floods were documented. LPA Campbell requested 3 of 18 client files for review and 3 of 15 files for staff for review. All files were found to be complete and all staff were found to be cleared.
Lisa RiosTELEPHONE: (916) 969-9685
Renee CampbellTELEPHONE: (916) 206-6380
DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2025
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LIFESPRING SENIOR CAMPUS, A WELLNESS COMMUNITY
FACILITY NUMBER: 507000962
VISIT DATE: 02/11/2025
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LPA Campbell consulted with the administrator to improve file presentation and to ensure files were complete for ease of access during future visits.

Per California Code of Regulations, Title 22, no deficiencies were observed during today’s visit. A copy of this report was provided to the facility
SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (916) 969-9685
LICENSING EVALUATOR NAME: Renee CampbellTELEPHONE: (916) 206-6380
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC809 (FAS) - (06/04)
Page: 2 of 2