Inspection
No deficiencies recorded in this report
PINE HOLLOW CARE HOME
8515 RAPOZO CT., Antelope CA 95843
6 bedsLatest official report Aug 28, 2025Licensed
Additional info
- Telephone
- (916) 628-6150
- Licensee
- MATSKEVICH, TATYANA
- Administrator
- MATSKEVICH, TATYANA
- Contact
- MATSKEVICH, TATYANA
- License first date
- Oct 21, 2009
- License effective date
- Oct 21, 2009
- District office
- SACRAMENTO NORTH ASC · (916) 263-4700
- Regional office
- 59
- Clients served
- 935 - ELDERLY
Summary
The available records show 1 Type B deficiency for this facility.
- Most recent inspection
- Aug 28, 2025
- Most recent deficiency
- Oct 8, 2021
5 later reports, from Oct 20, 2021 through Aug 28, 2025, recorded no deficiencies, though the records do not say whether they were follow-ups.
What Type A and Type B mean
- Type A
- 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
- Violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care.
Both classifications are published by California CDSS and are shown as published. SeniorLivingFacts does not rename them or add a severity level of its own.
At a glance
Counts cover the five-year public record. Typical figures are the median for the 598 Sacramento County facilities licensed for 6 or fewer beds.
In the available public five-year record, CCLD published 6 reports for this facility: 5 inspections, 1 complaint investigation, and 0 licensing or administrative records.
Those records contain 0 Type A and 1 Type B deficiencies.
0 deficiencies have explicit official correction or clearance evidence in the loaded records.
- Official inspections
- 5
- Recorded deficiencies
- 1
- Type A deficiencies
- 0
- Type B deficiencies
- 1
- Substantiated complaints
- 0
- Repeated topics
- 0
About the same as most this size
0 in the last 12 months
About the same as most this size
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Most this size have none
0 in the last 12 months
Most this size also have none
0 in the last 12 months
Last 36 months
No inspection in the last 12 months, so a zero above means no record rather than a clean visit.
Repeated topics
Topics cited in more than one report during the last 36 months. A repeat may show a pattern worth asking about. Each date opens its report below.
No topic repeats in the last 36 months
No deficiency topic appears in more than one report during that window. This does not establish that nothing repeated earlier in the five-year record, and it is not a statement about current conditions.
Official report history
All preserved reports from the most recent to the oldest, sortable by report type.
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Inspection
No deficiencies recorded in this report
Complaint
Allegations0 substantiated · 1 unsubstantiated · 0 unfounded
No deficiencies recorded in this reportInspection
Admission, assessment, and evictionType B
- Official classification
- Type B
- Official code
- 874579(c)(1)
- Regulation authority
- CCR
What the official deficiency says
87457(c)Prior to admission a determination of the prospective resident's suitability for admission shall be completed and shall include an appraisal of his/her individual service needs (1)The appraisal shall include, at a minimum, an evaluation of the prospective resident's functional capabilities, mental condition and an evaluation of social factors. Facility has not filled out a Needs and Services plan (LIC625) for resident which poses an immediate health and safety concern for the resident
Official plan of correction
Administrator to fill out resident's Needs and Service Plan (LIC625) or similar form, maintain it in resdient's file, and email a copy to Licensing by POC date.
Deadline recorded: Oct 15, 2021. A deadline is not proof that correction was completed.
Plan of correction recorded
Correction deadline recordedDeadline Oct 15, 2021
Correction not verified in available records
Source and limits
California Department of Social Services, Community Care Licensing Division. Public facility history is described by the source as a five-year window. Older records and previous-licensee history may require a regional-office request. Type 741 RCFE-CCRCs, nursing homes, and other care settings are excluded from this page.
Read the data methodology