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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 236800285
Report Date: 03/27/2024
Date Signed: 03/27/2024 11:43:50 AM

Document Has Been Signed on 03/27/2024 11:43 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:REDWOOD COAST SENIORS, INC.FACILITY NUMBER:
236800285
ADMINISTRATOR:ELIZABETH MORTONFACILITY TYPE:
775
ADDRESS:490 NORTH HAROLDTELEPHONE:
(707) 964-0443
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY: 30CENSUS: 2DATE:
03/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Roshan AshfordTIME COMPLETED:
12:00 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
At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility unannounced, to conduct an Annual required inspection. LPA met with Day Program Coordinator Roshan Ashford. This Day Program operates Monday thru Thursday 10:00AM to 2:00PM. LPA toured the Day Program and found it to be clean and in good repair. The Day Program consists of a large activity room with several tables and sitting areas for participant use. There were shelves containing various activity supplies. There is a large gardening area outside for use when weather permits.
Facility has fire sprinklers throughout and a carbon monoxide detector was present in the building. Water temperature was not within regulation, and the building maintenance personnel were contacted to adjust the temperature.
At approximately 9:45AM, LPA reviewed 6 participant records. Records contained the required documentation. LPA provided information regarding Admission Agreements, Medical assessments, Reporting Requirements and Needs and Service Plans.
The Day Program utilizes volunteers to assist when participants are present, and are supervised at all times by a full time staff. Staff records reviewed contained all the required information, including First aid and CPR certification.

No citations were issued during today's visit.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 03/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/27/2024
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 1