SeniorLivingFacts.com
Menu
Back

FIVE STAR RCFE 1 INC

6512 STAR BIRD CT, Elk Grove CA 95758

Facility 342701387 · RESIDENTIAL CARE ELDERLY (740)

6 bedsLatest official report Mar 19, 2026Licensed

Additional info
Licensee
FIVE STAR RCFE 1 INC
Administrator
CARIDAD, AMY ROSE
Contact
CARIDAD, AMY ROSE
License first date
Apr 24, 2024
License effective date
Apr 24, 2024
District office
SACRAMENTO SOUTH ASC · (916) 263-4700
Regional office
27
Clients served
983 - RCFE / DEMENTIA

Summary

The available records show 1 Type A and 5 Type B deficiencies for this facility.

Most recent inspection
Mar 19, 2026
Most recent deficiency
Mar 19, 2026

No later report is available, so the records do not show what happened afterward.

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 4 reports for this facility: 2 inspections, 1 complaint investigation, and 1 licensing or administrative record.

Those records contain 1 Type A and 5 Type B deficiencies.

0 deficiencies have explicit official correction or clearance evidence in the loaded records.

Official inspections
2

Fewer than the typical 5

1 in the last 12 months

Recorded deficiencies
6

Well above the typical 1

1 in the last 12 months

Type A deficiencies
1

Most this size have none

0 in the last 12 months

Type B deficiencies
5

Most this size have none

1 in the last 12 months

Substantiated complaints
1

Most this size have none

0 in the last 12 months

Repeated topics
0

Last 36 months

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
All report typesInspectionComplaintLicensing record
Inspection
Licensing and administrationType B
Official classification
Type B
Official code
1569.618(c)(3)
Regulation authority
HSC

What the official deficiency says

(c)The facility shall employ, and the administrator shall schedule, a sufficient number of staff members to do all of the following: (3) Ensure that at least one staff member who has cardiopulmonary resuscitation (CPR) training and first aid training is on duty and on the premises at all times. This paragraph shall not be construed to require staff to provide CPR. This requirement is not met as evidenced by: Deficient Practice Statement Based on records review, the licensee did not comply with the section cited above in 3 out of 3 counts which poses a potential health and safety risk to persons in care. During staff records review, LPA did not observe documentation of current CPR training for 3 facility staff.

Official plan of correction

POC Due Date: 03/27/2026 Plan of Correction Licensee agrees to replace missing CPR training certification records for 3 facility staff or provide training resource for re-training of CPR certification for facility staff by 3/27/2026. Licensee agrees to provide proof of CPR certification to LPA via email at shakaricka.hughes@dss.ca.gov by 3/27/2026.

Plan of correction recorded
Correction not verified in available records
View official report
View official source
Inspection
Incident reportingType B
Official classification
Type B
Official code
87211(a)(1)
Regulation authority
CCR

What the official deficiency says

(1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days of the occurrence of any of the events specified in (A) through (D) below. This report shall include the resident's name, age, sex and date of admission; date and nature of event; attending physician's name, findings, and treatment, if any; and disposition of the case. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, a death report was not submitted for R5, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/17/2025 Plan of Correction Licensee agrees to provide LPA Moleski with R5's death report and with a statement acknowledging reporting requirements by POC due date. vincent.moleski@dss.ca.gov

Plan of correction recorded
Correction not verified in available records
View official report
Staffing, personnel, and trainingType B
Official classification
Type B
Official code
87411(c)(1)
Regulation authority
CCR

What the official deficiency says

(1) Staff providing care shall receive appropriate training in first aid from persons qualified by such agencies as the American Red Cross. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, at least one staff member had expired first aid/CPR certification, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/17/2025 Plan of Correction Licensee agrees to provide LPA Moleski with an updated first aid/CPR certification for all outstanding staff members by POC due date.

Plan of correction recorded
Correction not verified in available records
View official report
Admission, assessment, and evictionType B
Official classification
Type B
Official code
87463(a)
Regulation authority
CCR

What the official deficiency says

(a) The pre-admission appraisal, as specified in Section 87457, Pre-Admission Appraisal, shall be updated, in writing as frequently as necessary or once every 12 months, whichever occurs first, to note significant changes in condition, as defined in Section 87101, Definitions, and to keep the appraisal accurate. For the purposes of this section, the updated pre-admission appraisal shall be referred to as the reappraisal. This requirement is not met as evidenced by: Deficient Practice Statement Based on record review, multiple residents had expired appraisals/needs and services plans, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/24/2025 Plan of Correction Licensee agrees to provide LPA Moleski with updated and signed appraisals and needs and services plans for all four residents by POC due date. vincent.moleski@dss.ca.gov

Plan of correction recorded
Correction not verified in available records
View official report
Fire safety and emergency preparednessType B
Official classification
Type B
Official code
1569.695(c)
Regulation authority
HSC

What the official deficiency says

(c) A facility shall conduct a drill at least quarterly for each shift. The type of emergency covered in a drill shall vary from quarter to quarter, taking into account different emergency scenarios. An actual evacuation of residents is not required during a drill. While a facility may provide an opportunity for residents to participate in a drill, it shall not require any resident participation. Documentation of the drills shall include the date, the type of emergency covered by the drill, and the names of staff participating in the drill. This requirement is not met as evidenced by: Deficient Practice Statement Based on interview, emergency disaster drills were not conducted and/or recorded, which poses/posed a potential health, safety or personal rights risk to persons in care.

Official plan of correction

POC Due Date: 03/17/2025 Plan of Correction Licensee agrees to provide LPA Moleski with a written acknowledgement of this requirement, and a schedule of planned drills for the remainder of this year by POC due date. vincent.moleski@dss.ca.gov

Plan of correction recorded
Correction not verified in available records
View official report
View official source

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