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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 552700409
Report Date: 04/13/2023
Date Signed: 04/13/2023 11:42:28 AM


Document Has Been Signed on 04/13/2023 11:42 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:SONORA SENIOR LIVINGFACILITY NUMBER:
552700409
ADMINISTRATOR:ERNEST G GIBSONFACILITY TYPE:
740
ADDRESS:18760 CHABROULLIAN LNTELEPHONE:
(209) 984-5124
CITY:JAMESTOWNSTATE: CAZIP CODE:
95327
CAPACITY:90CENSUS: 33DATE:
04/13/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Robert CantoriaTIME COMPLETED:
12:00 PM
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Assistant Program Administrator (APA) Pam Gill, Licensing Program Manager (LPM) Stephen Richardson, and Licensing Program Analyst (LPA) Christina Valerio arrived announced to the facility to attend a Town Hall Meeting at the facility coordinated by the State Long Term Care Ombudsman (SLTCO) Team.

The purpose of the Town Hall is to discuss the current Temporary Suspension Order, effective 04/12/23, introduce the Temporary Manager, Robert Cantoria, allow open discussion for comments and concerns from families, and introduce local licensed agencies for possible resident placement.

Present in the meeting from SLTCO: Jill Hernandez, Alyeah Ramos. Present in the meeting from Local Long Term Care Ombudsman (LTCO): Jill, Janice, and Sally. Present in the meeting from Area on Aging - Area 12: Kristin M. Roughly 30 family members and residents were also present in the meeting.

Licensees/Directors from the following agencies were present to offer their services and express bed availability: El Rio, Dale Commons, Astoria, Graceful Living Senior Care, Golden Living, Aspen Village, A Place for Mom, Assist Care - Gold Quartz Retirement Home, Assist Care - Oak Manor, Assist Care - Amador Residential Care Facility

Community Care Licensing Team to initiate daily calls with Temporary Manager Robert Cantoria to ensure compliance with Title 22 regulations, to receive an updated resident roster, to ensure the residents in care health and care needs are being met, and to discuss relocation sites for residents that have been relocated..

Per California Code of Regulations (CCR) - Title 22, Division 6, Chapter 8, no deficiencies were observed. Exit interview held with Temporary Manager Robert Cantoria, and a copy of the report was provided.
SUPERVISOR'S NAME: Stephen RichardsonTELEPHONE: (916) 263-4746
LICENSING EVALUATOR NAME: Christina ValerioTELEPHONE: 916-823-6323
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023
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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