525002362-6-17-2026-59-AS-RKNT-DV5RQY-20260617131420

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 525002362
Report Date: 06/17/2026
Date Signed: 06/17/2026 01:14:49 PM

Document Has Been Signed on 06/17/2026 01:14 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:	SAIL HOUSE, INC., THE		FACILITY NUMBER:	525002362
ADMINISTRATOR/ DIRECTOR:	CAREY, MICAH		FACILITY TYPE:	735
ADDRESS:	21125 LUTHER ROAD		TELEPHONE:	(530) 527-5780
CITY:	RED BLUFF	STATE: CA	ZIP CODE:	96080
CAPACITY: 23		CENSUS: 23	DATE:	06/17/2026
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:55 AM
MET WITH:	Shara King - administrator		TIME VISIT/ INSPECTION COMPLETED:	01:10 PM

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06/17/2026 11:55 AM Licensing Program Analyst Rebecca Knight conducted an unannounced case management visit and met with administrator Shara King. Today’s visit is regarding an incident that occurred on 05/14/2026.

It was reported that on 05/14/2026 4:15 AM Client 1 (C1) was playing music at maximum volume in their room, which woke up all of the other residents. Staff 1 (S1) called the on-call administrator, Staff 2 (S2, and Staff 3 (S3). S2 and S3 arrived and attempted to reason with C1 to turn down the radio. C1 stood up and attempted to stop both staff, punching S2 twice in the process. S3 contacted EMS when C1 left the facility to walk down the middle of Luther Road. C1 began making suicidal ideation comments. S3 and S2 attempted to intervene, following C1 while using their phones to alert oncoming traffic over a situation in the road and attempted to move C1 out of the street. After a short time, C1 pushed S2 and S3 out of the way, jumped in front of an oncoming vehicle, made contact with the side of the vehicle and rolled several times on the ground. C1 remained on the ground until EMS arrived. EMS transported C1 to the hospital for medical evaluation and subsequently placed on a 5150 hold by Tehama County Crisis Response.

During the course of the investigation, it was learned that C1 attempted to walk in front of cars three times and was not struck by a vehicle but was close enough to make contact with one vehicle which knocked C1 to the ground. C1 was in the hospital for about one month after the incident for mental health observation. C1 is now back living in the facility.

In order to prevent this from happening again the facility has increased mobile crisis unit intervention for C1. Any time C1 starts to exhibit signs of depression the mobile crises unit is called. The mobile crisis unit provides counseling and assistance for C1. C1's physician has modified their medication to reduce their anxiety level. C1 has been to two follow-up appointments with their physician to monitor their medications.

No deficiencies were cited as a result of today’s visit. Exit interview conducted and a copy of the report was provided to administrator Micah Carey.

NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Rebecca Knight
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 06/17/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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