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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 515002770
Report Date: 01/23/2024
Date Signed: 01/23/2024 02:22:29 PM

Document Has Been Signed on 01/23/2024 02:22 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:MERAKEY - FRANKLINFACILITY NUMBER:
515002770
ADMINISTRATOR:AGEE, KENNETHFACILITY TYPE:
737
ADDRESS:2888 FRANKLIN ROADTELEPHONE:
(760) 571-0953
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY: 4CENSUS: DATE:
01/23/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Program Director: Kenneth AgeeTIME COMPLETED:
01:30 PM
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A Microsoft Teams meeting was held today 1/23/2024 at 1pm to discuss the approval of 3 day eviction request.

The attendees of the meeting were: Representatives of Community Care Licensing (CCL) Regional Manager Alycia Berryman, Licensing Program Manager (LPM) Troy Ordonez, LPM Laura Munoz, Licensing Program Analyst (LPA) Sarena Keosavang, representative(s) of Alta Regional Center: John Decker, Mechelle Johnson, Amy McCreary, Jordan Eller and Merakey-Franklin representative(s), Regional Director Chanese Thomas, Vice President Beth Caraccio, Senior Executive Director Alisa Dean, Nurse Director Marilou Malvar, Program Director Kenneth Agee, Clinical Director Alex Compton, RN Lucien Kennedy.

Topics discussed during the meeting were:
  • Approved 3-day eviction by the Department.
  • The Department’s expectations on continuous care for the resident.
  • Resident’s behaviors.
  • Resident’s current medications.

CCL will do the following:
  • Continue to collaborate with community partners.

The Facility will do the following:
  • Continue to communicate and collaborate with ACRC, DDS, CCL
  • The department is recommending Merakey – Franklin work with Alta California Regional Center to create a transition plan for C1.

No deficiencies are being cited for today’s meeting.

Exit interview conducted and a copy of this report will be provided to the facility via email. A copy will be signed and returned to community Care Licensing.
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Sarena Keosavang
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2024
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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