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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 525920151
Report Date: 08/27/2024
Date Signed: 08/27/2024 01:47:55 PM

Document Has Been Signed on 08/27/2024 01:47 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:SENTINELFACILITY NUMBER:
525920151
ADMINISTRATOR/
DIRECTOR:		PHELPS, ASHELYFACILITY TYPE:
735
ADDRESS:22870 TUSCAN AVENUETELEPHONE:
(530) 200-2909
CITY:RED BLUFFSTATE: CAZIP CODE:
96080
CAPACITY: 4CENSUS: 0DATE:
08/27/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Ashley Phelps - licenseeTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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08/27/2024 01:00 PM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility to conduct their scheduled pre-licensing inspection. LPA met with Licensee Ashley Phelps, and administrator Tiffany England and explained the purpose of the visit.

LPA toured the facility inside and out. The inside of the facility was observed to be in good condition and repair. The facility has received fire clearance for two (2) ambulatory and two (2) non-ambulatory clients. The facility has four (4) bedrooms and two (2) bathrooms which are in good condition and ready for use. There is one (1) bedroom that will be used as a staff room. There is a locked office that where facility files will be stored.



There is a laundry room with washer and dryer in place and ready for use. Laundry, cleaning supplies and toxins will be locked in supply room which is next to the laundry room.

There is a dining room with table and chairs for clients to use. LPA observed a large sofa and two easy chairs in the common area that provide ample seating for the clients.

Food storage meets Title 22 regulation requirements. Plates, utensils, pots, and pans were in place during the inspection. Dishwasher, stove, microwave and refrigerator were all present and ready for use.

The facility has (1) fully charged fire extinguisher which was inspected by the fire marshal. LPA observed smoke alarms and carbon monoxide detectors fully functioning. Bedrooms were observed to have furniture as required by Title 22 Regulations. All beds were made up with linens and bedspreads. Each client room has towels and face cloths available for the clients to use. Continued on LIC809-C
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SENTINEL
FACILITY NUMBER: 525920151
VISIT DATE: 08/27/2024
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There are two fireplaces in the facility that are non-functioning and for esthetics only. The flu in each fireplace is blocked. The fireplaces cannot be removed due to them being a part of the structural integrity of the home.


Storage and lighting are adequate in the home. Medications are to be locked up in a locking room. Also locked in the kitchen are knives.

There is a covered patio with outdoor furniture for the clients to use in the backyard.

The applicant has passed the pre-licensing portion of the application process. LPA will contact the Central Application Bureau.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
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