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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347001498
Report Date: 08/13/2026
Date Signed: 08/13/2026 04:28:17 PM

Document Has Been Signed on 08/13/2026 04:28 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:CITRUS HEIGHTS TERRACEFACILITY NUMBER:
347001498
ADMINISTRATOR/
DIRECTOR:		MAGDA LUISFACILITY TYPE:
740
ADDRESS:7952 OLD AUBURN ROADTELEPHONE:
(916) 727-4400
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY: 49CENSUS: 49DATE:
08/13/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Rachael Robert, Resient Care Coordinator TIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Sabrina Calzada arrived unannounced to conduct a case management inspection and met with Rachael Robert, Resident Care Coordinator (RCC) and then the Interim Administrator, Magda Luis. LPA stated the reason for the inspection was to follow up on an incident report (LIC624) submitted to the Department on August 11, 2026. There are currently (5) residents under hospice care. LPA observed new flooring being installed in the north wing during today's inspection. LPA and RCC discussed the following:

Resident (R1) walked out of the community, unassisted, through the front door, on Monday, August 10, 2026 (at 5:09 pm). The concierge had just left their shift at 5:00 pm and there was no staff present in the lobby at the time of the incident. The RCC explained that staff were conducting a mandatory head count of residents shortly after dinner was finished and realized (R1) was not in the building. A mandatory head count was completed during dinner and (R1) was present in the dining room.

Staff contacted the Administrator, RCC, responsible person and 9-1-1 at approximately 5:40 pm. At 6:40 pm, local police brought (R1) back to the community after locating them walking in the nearby area. Staff did not observe any visible injuries to (R1) upon returning to the community, and (R1) will follow up with their primary care physician. The family member indicated that (R1) used to try and elope when living at home with them and is very active.

The RCC indicated that the alarm on the front exit door did not sound when the door was opened at 5:09 pm, and it was determined to be a "temporary malfunction". The facility confirmed that the door alarm was working correctly just prior to (R1) leaving, based on staff interview/s and camera footage. Maintenance staff tested and ensured the door alarm was working correctly the next morning, on August 11, 2026.
*cont on 809C-1..
Lauren Crocker
Sabrina Calzada
DATE: 08/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2026
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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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: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498
VISIT DATE: 08/13/2026
NARRATIVE
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809C-1.. The RCC indicated that (R1) had been wearing a bracelet (Wanderguard) since moving in in May 2026 and provided paperwork showing that staff were monitoring twice daily that (R1) was wearing it. The RCC explained that the "am" shift had confirmed (R1) was wearing the bracelet during their shift and the "pm" also completes mandatory two hour checks, but when they went to check prior to (R1) leaving, (R1) was not found.

The RCC stated (R1) has taken off their bracelet at various times prior to the incident, has not previously tried to exit from the facility, and must have removed the bracelet on August 10, 2026, between 3:00 pm and 5:00 pm, prior to the exiting from the building. The RCC added that (R1) was not wearing the bracelet as the Wanderguard alarm did not sound at the time of exiting the building. Initially, (R1) wore a necklace (Wanderguard) but then switched to wearing a bracelet for a brief period. (R1) has been wearing an anklet device following the incident and has not tried to take it off.

Following the incident, the facility completed an Elopement Risk Evaluation, a Resident Re-Appraisal, and updated (R1's) care plan. The RCC added that (R1) tends to walk around the community and also be near the lobby area on a regular basis. The facility is looking into obtaining a second staff to sit at the concierge area into the early evening, while visiting hours occur.

Currently, (30) seconds are required to hold the exit door handle before the alarm sounds, which was an increase from (15) seconds previously. The RCC stated that staff are testing the exit door alarm at least once during each shift and when staff are using the door to enter/leave the community. Staff will continue to complete "End of Shift Reports" and Narrative Charting when observing residents.

LPA observed (R1) participating in an activity with other residents in the dining room and to be wearing an anklet device. LPA observed the RCC to test the front egress door and staff to respond timely, within (30) seconds. The RCC and Interim Administrator stated there are discussions about adding a gate inside the lobby for additional security measures.

Per California Code of Regulations, Title 22, Division 8, Chapter 6, the following (1) deficiency is being cited related on the 809-D page.

Exit interview. Copy of report and appeal rights provided.
NAME OF LICENSING PROGRAM MANAGER: Lauren Crocker
NAME OF LICENSING PROGRAM ANALYST: Sabrina Calzada
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2026
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 08/13/2026 04:28 PM - It Cannot Be Edited


Created By: Sabrina Calzada On 08/13/2026 at 04:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CITRUS HEIGHTS TERRACE
FACILITY NUMBER: 347001498

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/13/2026
Section Cited
HSC
1569.699(5)

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§1569.699 Exit doors; egress-control devices of time-delay type; fences (a) When approved by the person responsible for enforcement, as described in Section 13146, exit doors in facilities classified as Group R, Division 2 facilities under the California Building Standards Code, licensed as residential care facilities for the elderly, and housing clients with Alzheimer’s disease or major neurocognitive disorder, may be equipped with approved listed special egress-control devices of the time-delay type, provided the building is protected throughout by an approved automatic sprinkler system and an approved automatic smoke-detection system. The devices shall conform to all of the following requirements: (5) Actuation of the panic bar or other door-latching hardware shall activate an audible signal at the door. This requirement is not met as evidenced by:
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Licensee/Administrator already conducted staff training with the "pm" shift on the August 10, 2026. Training to be scheduled for the "am" and "NOC" shifts - will conduct training at their cross-over within a week, or by 8/20/2026.
Maintenance already increased the time from (15) seconds to (30) seconds until the egress door opens after the alarm is sounded.
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Based on interview with the Interim Administrator and Resident Care Coordinator, the Licensee did not ensure that the egress door alarm sounded on Monday, August 10, 2026 (5:09 pm) when (R1) was able to exit from the community, unassisted, which posed an immediate health and safety risk to residents in care.
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Additionally, maintenance will possibly change a part in the magnetic box if it's determined to be related to the alarm not sounding. The facility has started the process of placing a staff person at the concierge from 5-8 pm. Lastly, the facility is in discussions about adding an interior security door that clients would have to go through before they are able to reach the egress door. The facility agrees to provide any updates/documentation related to these follow up actions, to the Department, by August 27, 2026.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Lauren Crocker
NAME OF LICENSING PROGRAM MANAGER:
Sabrina Calzada
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 08/13/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/13/2026


LIC809 (FAS) - (06/04)
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