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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157202415
Report Date: 10/09/2024
Date Signed: 10/09/2024 11:41:13 AM

Document Has Been Signed on 10/09/2024 11:41 AM - 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SAILS RIDGECREST ADULT DAY PROGRAMFACILITY NUMBER:
157202415
ADMINISTRATOR/
DIRECTOR:		SARABIA, ANGIEFACILITY TYPE:
775
ADDRESS:126 S CHINA LAKE BLVDTELEPHONE:
(661) 855-3740
CITY:RIDGECRESTSTATE: CAZIP CODE:
93555
CAPACITY: 60CENSUS: 14DATE:
10/09/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:16 AM
MET WITH:Program Director Angie SarabiaTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Shawna Doucette and Brianna Miranda arrived at the facility unannounced to conduct the Required Annual Inspection. LPA met with Program Director Angie Sarabia. LPA disclosed the purpose of the inspection and was granted entry into the facility by Program Director Angie Sarabia.

A tour of the facility was conducted with Program Director. The facility was set at 75 F temperature and free of passageway obstructions inside and outside. The water temperature was measured at 100.1 F.

Kitchen was toured. Cleaning supplies were in a locked in a storage room. Smoke detectors and carbon monoxide detectors were checked and operating. Fire extinguishers were charged and had service dates of 03/28/24. Fire drill was last completed on 06/13/24.

Client and staff records were reviewed. Current first aid and CPR were on file for staff. Facility does not administer medications or serve food.

Refer to 809D

An exit interview was conducted with the Program Director and a copy of this report with plan of correction and appeal rights was provided.

SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Shawna Doucette
LICENSING EVALUATOR SIGNATURE: DATE: 10/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/09/2024
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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Document Has Been Signed on 10/09/2024 11:41 AM - It Cannot Be Edited


Created By: Shawna Doucette On 10/09/2024 at 11:27 AM
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
, 1314 E SHAW AVE
FRESNO, CA 93710

FACILITY NAME: SAILS RIDGECREST ADULT DAY PROGRAM
FACILITY NUMBER: 157202415

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
82088(e)(1)
Fixtures, Furniture, Equipment, and Supplies
(1) Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above by the water temperature measuring at 100.1 F which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2024
Plan of Correction
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Licensee agrees to bring the water in compliance to measure in between 105 F to 120 F by POC due date 10/18/24. Licensee agrees to send a photo to Licensing.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Sergiy Pidgirny
LICENSING EVALUATOR NAME:Shawna Doucette
LICENSING EVALUATOR SIGNATURE:
DATE: 10/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/09/2024


LIC809 (FAS) - (06/04)
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