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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045920056
Report Date: 11/13/2024
Date Signed: 11/13/2024 01:26:43 PM

Document Has Been Signed on 11/13/2024 01:26 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:MERAKEY - INSPIRATIONSFACILITY NUMBER:
045920056
ADMINISTRATOR/
DIRECTOR:		HESLA, LISAFACILITY TYPE:
775
ADDRESS:3880 MORROW LANE, SUITE 30TELEPHONE:
(530) 774-2793
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY: 35CENSUS: DATE:
11/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Program Manager, Lisa HeslaTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On November 13, 2024 at approximately 10:45 AM, Licensing Program Analyst (LPA), Farhaan Sarangi arrived unannounced at Merakey-Inspirations for the purpose of conducting a Required 1 year inspection. LPA was greeted at the door by Program Manager, Lisa Hesla, and was granted access into the facility. Upon reviewing Guardian Background Clearances, LPA observed that 1 out of 5 caregivers do not have a background clearance on file (See LIC 809D and LIC 421 BG).

LPA and the Program Director toured the facility. LPA observed the facility to be clean and at a comfortable temperature with all exits free from obstruction. LPA observed a main area where clients do activities, conference room, changing room, supply room, locked toxins room where toxins are stored and isolation room. Clients were observed watching a movie. 3 of 3 Fire Extinguisher were found to be last charged on July 2023 at the time of the inspection (See LIC 9102-Technical Violation). Administrator reported that the fire extinguishers were not punched in on the year of 2024 by the Inspector and will follow up with the inspector. All smoke detectors and Carbon Monoxide Detectors sound directly to the Local Fire Jurisdiction. Water temperature was tested and found to be at 107 degrees within an acceptable range of 105 to 120 degrees. Clients bring their own lunches and the facility puts the lunches in plates to serve to the clients in care. Facility has snacks available for clients in care. Cleaning products and other toxins are locked and inaccessible to clients in care. There was a supply of cleaners, hygiene products and paper products available for clients and/or staff. All bathrooms designated for clients in the common areas at the facility were supplied with individual paper towels and hand soap. LPA advised facility to contact County Public Health and Community Care Licensing immediately if symptoms of COVID-19 or other infectious diseases are present in the facility. LPA reviewed the Emergency Disaster Plan and found that to be appropriate during the inspection. Infection Control Plan is currently being updated (See LIC 91902-Technical Violation) and will be sent once completed. Emergency Disaster Drill was conducted in August 2024. (Report continued on LIC 809C)
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: MERAKEY - INSPIRATIONS
FACILITY NUMBER: 045920056
VISIT DATE: 11/13/2024
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First Aid Kit was inspected and found to be appropriate during the inspection.

LPA observed that 1 out of 5 staff members do not have the required training as outlined in Title 22 regulations (See LIC 9102-Technical Violation), and the Administrator does not have 30 clock hours of training (See LIC 9102-Technical Violation). 1 out of 5 staff members did not have a valid First Aid/CPR Card (See LIC 9102-Technical Violation). LPA educated the Program Manager regarding ensuring that all staff members that provide care and supervision have First Aid/CPR Cards and that all staff have the required training annually. 5 of 5 client files were reviewed and found to be appropriate during the inspection.

LPA requested the following documents:

LIC 500- Personnel Report
LIC 308- Designation of Facility Responsibility
LIC 309- Administrative Organization
LIC 400-Affidavit Regarding Client Cash Resources
Most up-to-date Liability insurance
Most recent Fire Inspection Report
Control of Property
Register of clients
Updated Facility Sketch
Updated Infection Control Plan

Deficiencies cited from the California Code of Regulations, Title 22, Division 6, Chapter 3 of California Regulation. Appeal rights were provided. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in additional civil penalties. Exit interview was conducted, and a copy of this report was signed and given to the Administrator along with Appeal Rights.
SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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Document Has Been Signed on 11/13/2024 01:26 PM - It Cannot Be Edited


Created By: Farhaan Sarangi On 11/13/2024 at 12:29 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: MERAKEY - INSPIRATIONS
FACILITY NUMBER: 045920056

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
82019(e)
(e) Prior to working, residing or volunteering in a licensed day program, all individuals subject to a criminal record review pursuant to Health and Safety Code Section 1522 shall do the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on of 1 out of 5 staff members during a record review, the licensee did not comply with the section cited above in 1 out of 5 staff members did not have a background clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2024
Plan of Correction
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Licensee/Administrator shall fill out an LIC 9098 understanding of the regulation, conduct staff training on the regulation cited and provide a statement on how future compliance will be met.
Type A
Section Cited
CCR
82054(b)
(b) Notwithstanding Section 82054(a), an immediate penalty of $100 per cited violation per day for a maximum of five (5) days shall be assessed if any individual required to be fingerprinted under Health and Safety Code Section 1522(b) has not obtained a California clearance or a criminal record exemption, requested a transfer of a criminal record clearance or requested and be approved for a transfer of an exemption as specified in Section 82019(e) prior to working, residing or volunteering in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on of 1 out of 5 staff members during a record review, the licensee did not comply with the section cited above in 1 out of 5 staff members did not have a background clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/14/2024
Plan of Correction
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Civil Penalty Assessed in the amount of $100.00.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lauren Crocker
LICENSING EVALUATOR NAME:Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2024


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