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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125000990
Report Date: 10/05/2022
Date Signed: 10/05/2022 01:16:00 PM

Document Has Been Signed on 10/05/2022 01:16 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:HCAR - THE STUDIOFACILITY NUMBER:
125000990
ADMINISTRATOR:JANTZ, ROSSFACILITY TYPE:
775
ADDRESS:139 THIRD STREETTELEPHONE:
(707) 443-1428
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY: 30CENSUS: 11DATE:
10/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Sam WhitlachTIME COMPLETED:
01:30 PM
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At approximately 12:00PM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this licensed adult day program unannounced, to conduct an Annual Required infection control inspection. LPA met with Program Manager Sam Whitlach and toured the facility. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility has submitted an infection control plan. Posters are in place at the entrance and throughout the building. Hand sanitizer is available at the entrance of each section of the facility. Facility has PPE supplies. Artists are spaced apart in each section and do not share items. High traffic area's are sanitized several times a day and a thorough cleaning is conducted at the close of program each day. There are hand washing stations and hand sanitizer located throughout the building. There were currently 11 artists attending the day program. All staff and artists were wearing face coverings during this visit.

There were no deficiencies found in the areas inspected.

No citations issued.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 10/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/05/2022
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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