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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525002342
Report Date: 08/20/2024
Date Signed: 08/20/2024 12:46:39 PM

Document Has Been Signed on 08/20/2024 12:46 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:CASA SERENITY, LLCFACILITY NUMBER:
525002342
ADMINISTRATOR/
DIRECTOR:
PULEOCHANKIN,RACHELFACILITY TYPE:
735
ADDRESS:100 ORCHARD WAYTELEPHONE:
(530) 529-5114
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY: 16CENSUS: 16DATE:
08/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:10 AM
MET WITH:Rachel Puleo-Chankin - administratorTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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08/20/2024 11:10 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with administrator Rachel Puleo-Chankin and explained the purpose of the visit.

LPA Knight and the administrator toured the facility together to ensure the health and safety of clients in care. Areas toured include but are not limited to eight (8) client rooms, common areas, four (4) bathrooms, kitchen, storage areas, pool house and back yard. Staff and resident files were reviewed. All employees requiring background checks are cleared. Administrator certificate is current.

Recreational activities are planned around client schedules, appointments and are catered to the client's interests. Bedding, linens, and towels for clients were observed and found to be clean and in good repair. Medication is locked in a medication cabinet.

The facility was observed to be at a comfortable temperature. Hot water measured between 105 – 120 degrees F. Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Food appears to be stored and prepared properly. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food. Fire extinguishers fully charged and inspected. There is a pool on the premises that is located in a secured pool room. Last disaster drill was conducted in June 2024 which was an power outage, the facility has been conducting fire drills monthly.

In the areas toured no immediate health, safety, or personal rights violations were observed. No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was provided to administrator Rachel Puleo-Chankin

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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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