Sarah's Great Life

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Hannah Rodgers conducted an unannounced Required Annual Inspection. The facility file was reviewed prior to the visit. LPA was welcomed by and discussed the purpose of the visit to Facility Manager Brandee Geurkink. The facility's license shows a maximum capacity of six (6) non-ambulatory residents. Hospice waiver for three (3). During today’s inspection there were four (4) residents in care. LPA with Manager Geurkink toured the interior and exterior of the facility and inspected each room. Pathways were free of obstruction and slip hazards. Resident bedrooms contained the required furnishings. Doors, windows, screens, toilets, and showers were in working order. Extra linens and hygiene supplies were present. The facility had sufficient space and equipment to facilitate dining, laundry, visitation, meetings, and resident activities. The facility contained at least 2 days of perishable food, and at least 7 days non-perishable food, all safely stored. Cooking, dining equipment, and utensils were present. No toxic chemicals or poisons were accessible to residents. Medications were labeled, as required, and stored in locked areas. No pools or bodies of water exist on the premises. Per Manager Geurkink, no firearms or ammunition are kept at the facility. Carbon monoxide detectors, emergency lighting, and facility telephone were all in working order. Fire extinguishers were serviced within the last 12 months. First aid kits were complete and readily accessible. Required licensing postings were observed in visible areas of the facility. LPA reviewed facility records. The files reviewed by LPA contained required documents. Confidential records were stored in locked areas. No deficiencies were cited during the inspection. An exit interview was conducted with Manager Geurkink to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.the state’s words, verbatim · CDSS document, Nov 20, 2025

Type of visit: Required - 1 Year

On 11/15/2024 at 08:45 AM, Licensing Program Analyst (LPA) Melody Brown made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA Brown met with a staff and was granted entry to the facility. At the time of the visit there were two (2) staff present, and five (5) residents present. Licensee/Administrator Thomas Uata was contacted and informed of the visit. Staff #3 (S3) informed Facility Manager Brandee Geurkink of the visit. LPA Brown explained the purpose of the visit to Facility Manager Brandee Geurkink. The facility is a Residential Care Facility for the Elderly (RCFE). The facility is a four (4) bedroom, three (3) bathroom home with a kitchen/dining area, two (2) living room areas, laundry room and an attached two-car garage. The facility is licensed for a capacity of six (6) non-ambulatory residents. The current census is five (5) residents. LPA Brown was accompanied by Facility Manager Geurkink to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating in the capacity approved by Community Care Licensing Division (CCLD). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature of 75 degrees Fahrenheit. LPA Brown inspected resident bedrooms; they are equipped with required furniture such as: mattresses, night stands, and storage space. However, LPA Brown observed insufficient lighting on resident bedrooms to ensure the comfort and safety of residents at the facility. Deficiency will be issued. Also, LPA Brown observed no chairs provided on resident bedrooms. Technical Violation will be issued. Moreover, LPA Brown observed that bathrooms were clean, and appliances were operating appropriately. LPA Brown observed sufficient furniture throughout the facility. LPA Brown measured and observed the water temperature in the residents shared bathroom to be at 106.8 degrees Fahrenheit. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCLD complaint poster, ombudsman poster, labor laws, and the disaster plan were posted in a common area. ***Continuation in LIC809C*** Cleaning supplies were kept inaccessible to residents in care, however, LPA Brown observed one (1) sharp scissor and two (2) sharp peelers in the kitchen drawer, not locked and accessible to residents in care. Deficiency will be issued. To add to that, LPA Brown did not observe night lights maintained in hallways and passages to non-private bathrooms. Deficiency will be issued. During the tour of the facility, LPA Brown observed that the facility does not have the required emergency supplies, emergency food and emergency water. Deficiency will be issued. There was a designated storage space for resident/staff files. Medications are kept in the medication room. LPA Brown observed he facility is clean and in good repair for residents in care. Food Service: Seven (7) days non-perishable and two (2) days perishable food supply observed at the facility. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Also, LPA Brown noted that there's a staff scheduled to work the night shift as required for facility with dementia residents. Record Review: LPA Brown observed Infection Control Plan, dementia care plan and the required updated liability insurance maintained at the facility. Also, LPA Brown reviewed three (3) resident files for admission agreements, updated physician reports, pre-placement appraisals, needs and services plans and centrally stored medication list. LPA Brown observed missing Resident/Responsible Party Signature and Signature Date and Licensee or LIcensee's designated Representative Signature and Signature date in Resident #3 (R3) Admission Agreement. Deficiency will be issued. Also, LPA Brown observed that Resident #3 (R3) does not have R3's signature/Responsible Person signature and signature date and Resident #2 (R2) Pre-Admission Appraisal does not have R2's Responsible Person signature date. Deficiency will be issued. LPA reviewed three (3) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings with tuberculosis (TB) test results. LPA Brown noted that the files reviewed were complete. Medications/Medication Administration Records (MARs) were audited for three (3) residents and appeared to be dispensed and logged appropriately. Based on the observations made during today’s visit, deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809), LIC809D and Appeal Rights were discussed and provided to Facility Manager Brandee Geurkink.the state’s words, verbatim · CDSS document, Nov 15, 2024

The state marks this report as 7 pages; the online copy we transcribed has 6. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

Licensing Program Analyst (LPA) Ryan Gardner made an unannounced visit to the facility. The purpose of the visit was to conduct a required comprehensive annual inspection. LPA met with Facility Manager Brandee Geurkink and was granted entry to the facility. The facility is a Residential Care Facility for the Elderly (RCFE). The facility is a four (4) bedroom, three (3) bathroom home with a kitchen/dining area, two (2) living room areas, and an attached garage. The facility is licensed for a capacity of six (6) non-ambulatory residents. The current census is five (5) residents. LPA was accompanied by Facility Manager to conduct a general overall inspection, which included, but was not limited to, the following: Physical Plant: The facility is operating within the capacity approved by Community Care Licensing (CCL). There are no obstructions to interior and exterior passageways. The facility is maintained at a comfortable temperature. LPA inspected resident bedrooms; they are equipped with required furniture such as: mattresses, nightstands, storage space, and sufficient lighting; bathrooms were clean, and appliances were operating appropriately. LPA observed sufficient furniture and lighting throughout the facility. LPA measured and observed the water temperature in the bathroom to be at 106.1 degrees F. The facility is equipped with operating smoke detectors and carbon monoxide alarms. Postings such as the facility license, personal rights, the CCL complaint poster, and the disaster plan were posted in a common area. Cleaning supplies, toxins, sharps, and other dangerous items were kept inaccessible to the residents in care. There was a designated storage space for resident files and staff files. Medications are kept inside a cabinet in the laundry room inaccessible to residents. The facility has a first aid kit stored in the laundry room. Food Service: Non-perishable and perishable food supply is sufficient for the residents in care. Care & Supervision: Facility has sufficient care staff for coverage 24 hours a day, 7 days a week. Record Review: LPA reviewed two (2) resident files for admission agreements, updated physician reports, and needs and services plans. LPA reviewed two (2) staff files for First Aid/CPR certification, criminal record clearance, trainings, and health screenings. Medications/MARs records were audited and appeared to be dispensed and logged appropriately. Based on the observations made during today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC809) was discussed and provided to Facility Manager Brandee Geurkink.the state’s words, verbatim · CDSS document, Nov 27, 2023