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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515000683
Report Date: 01/17/2024
Date Signed: 01/17/2024 03:46:05 PM


Document Has Been Signed on 01/17/2024 03:46 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 NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:COURTYARD, THEFACILITY NUMBER:
515000683
ADMINISTRATOR:BRANDY STRAHLFACILITY TYPE:
740
ADDRESS:1240 WILLIAMS WAYTELEPHONE:
(530) 790-3050
CITY:YUBA CITYSTATE: CAZIP CODE:
95991
CAPACITY:80CENSUS: 56DATE:
01/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Brandy StrahlTIME COMPLETED:
03:55 PM
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LPA Hiratsuka, conducted this unannounced annual visit. LPA toured with Administrator Brandy Strahl.

This facility is on a campus surrounded by a wrought iron fence that has a gate for cars and an unlocked pedestrian gate. This campus also has a skilled nursing on it and behind this building is The Gardens 515001365. The buildings share common pedestrian areas and this building and the skilled nursing share the parking lot. This facility 54 resident rooms and all have full private bathrooms. There are two restrooms for staff and residents. There is a laundry room that is used mainly by staff but residents may use it if they wish. There are several small common areas, one large dining/activity room, and the front area has offices on the left and a small activity room on the right.

Several topics were discussed.

Several staff and resident files were reviewed.

No deficiencies cited.
SUPERVISOR'S NAME: Troy OrdonezTELEPHONE: (916) 263-4700
LICENSING EVALUATOR NAME: Kerry HiratsukaTELEPHONE: (916) 591-0210
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2024
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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