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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125001177
Report Date: 12/19/2022
Date Signed: 12/19/2022 12:16:31 PM

Document Has Been Signed on 12/19/2022 12:16 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 BAY CENTERFACILITY NUMBER:
125001177
ADMINISTRATOR:JANTZ, ROSSFACILITY TYPE:
775
ADDRESS:1001 SEARLESS STREETTELEPHONE:
(707) 441-8625
CITY:EUREKASTATE: CAZIP CODE:
95501
CAPACITY: 75CENSUS: 30DATE:
12/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Wes PattersonTIME COMPLETED:
12:30 PM
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At approximately 11:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this licensed adult day program unannounced, to conduct an Annual Required infection control inspection. LPA arrived at the facility and had temperature checked and health questions asked. Facility was found to be clean and at a comfortable temperature with all exits free from obstruction. LPA met with Program Director Wes Patterson and toured the facility. Posters are in place at the entrance and throughout the building. The entrance area has a counter with hand sanitizer, thermometer and other items designated for Clients, Staff and visitors before coming into the facility. Facility has PPE supplies stored in the supply closet. There were hand washing stations and hand sanitizer located throughout the building. Client activity areas are set up with tables that are spaced apart to allow distancing.

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: 12/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/19/2022
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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