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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507000962
Report Date: 02/19/2025
Date Signed: 02/19/2025 03:40:00 PM

Document Has Been Signed on 02/19/2025 03:40 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: 40CENSUS: 18DATE:
02/19/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:45 PM
MET WITH:Cynthia McDaniel, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:45 PM
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On 02/19/25, Licensing Program Analyst (LPA) Renee Campbell arrived unannounced regarding a denied exemption request. LPA Campbell met with Cynthia McDaniel, Administrator and explained the purpose of the request.

Upon entry to the facility dining area, LPA Campbell observed Jamie Vierra.Siupervisor assisting residents with a meal. LPA Campbell asked the supervisor if they had seen S1 in the facility. Supervisor Vierra stated no, S1 had been gone from the facility for some time. LPA Campbell then continued to the administrator's office. LPA Campbell then asked Administrator McDaniel if S1 was present and when S1 was last seen. Administrator McDaniel stated S1 had left the facility the same day notification of the denial exemption request for S1 was received on 11/19/2025. This was the last day S1 was seen in the facility..

Exit interview was conducted and a copy of this report was left at the facility. A copy of the court order was left at the facility as well.
SUPERVISORS NAME: Lisa Rios
LICENSING EVALUATOR NAME: Renee Campbell
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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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