<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 216800673
Report Date: 11/15/2024
Date Signed: 11/15/2024 02:51:55 PM

Document Has Been Signed on 11/15/2024 02:51 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:CH&S ENTERPRISE DAY SERVICEFACILITY NUMBER:
216800673
ADMINISTRATOR/
DIRECTOR:		ABATE, CHASFACILITY TYPE:
775
ADDRESS:405 NORMAN DRIVETELEPHONE:
(415) 883-4048
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY: 38CENSUS: 28DATE:
11/15/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Harold Williams, Program Director
Charles Abate, Licensee		TIME VISIT/
INSPECTION COMPLETED:
03:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
11/15/2024, Licensing Program Analyst (LPA) Loera conducted an unannounced Annual Required – 1 yr. inspection visit for this facility. Facility has an emergency disaster plan as required. Facility has an infection control plan as required. Out of the 38 clients, 6 clients can be non-ambulatory. Facility is an adult day care program. LPA met with Program Director, Harold Williams. Licensee, Charles Abate arrived shortly after.

At approximately 1:10pm, LPA and Program Director toured the building and grounds. The facility was found to be at a comfortable temperature. There are thirty-five (35) clients that are enrolled in day program. Today there are twenty-eight (28) clients in attendance.

LPA observed clients participating in activities during the tour. Facility has activities available to clients such as puzzles, games, art supplies, and various other activities. Water temperature in sinks accessible to clients were measured at 119.3 and 118.1 degrees F which is within the range of 105 to 120 degrees F. Fire extinguishers were last inspected 11/2024. Facility conducts fire drills twice a year with the last one being conducted 11/07/2024. Sharps, toxins, and chemicals were locked and secured in the hallway closet. Backyard was found to be clean with both emergency exit paths being obstruction free. Facility does not handle medications or client cash resources.

Facility conducts training every Thursday and keeps record in a training log.

LPA conducted a review of 4 client records. All records had the required documentation.

LPA conducted review of 4 staff records/training. Upon a review of staff records, LPA found all staff to have required annual and initial training as well as current 1st Aid & CPR certification on file. 1 out of 4 staff records had a missing health screening/tb sheet. Upon discussion with licensee, staff got health screening/tb done. Licensee states they will get a copy and put it in their staff file.

No deficiencies cited during today's inspection.

continued on LIC809-C
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: CH&S ENTERPRISE DAY SERVICE
FACILITY NUMBER: 216800673
VISIT DATE: 11/15/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Updated copies of the following documents were requested for facility file and are to be submitted to CCL within 30 days of this visit:

LIC500- Personnel Report
Emergency Disaster Plan (review, update if any changes)
Infection Control Plan (review, update if any changes)

Exit interview conducted with Licensee and a copy of this report was provided.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Anthony Loera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2