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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 236803321
Report Date: 02/03/2025
Date Signed: 02/03/2025 12:14:59 PM

Document Has Been Signed on 02/03/2025 12:14 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:ENHANCED SERVICESFACILITY NUMBER:
236803321
ADMINISTRATOR/
DIRECTOR:		BASHAW, SEANFACILITY TYPE:
775
ADDRESS:915 S. DORATELEPHONE:
(707) 489-1513
CITY:UKIAHSTATE: CAZIP CODE:
95482
CAPACITY: 40CENSUS: 10DATE:
02/03/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Rebecca WagnerTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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At approximately 10:45AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this licensed adult day program unannounced, to conduct an Annual Required inspection. LPA met with Program Manager Rebecca Wagner, toured the building and reviewed records. The Day Program was found to be clean and at a comfortable temperature with all exits free from obstruction. The indoor temperature was within regulation. LPA observed two main client areas, furnished with positioning mats and tables. This Day Program works with individuals mobility and range of motion.
LPA reviewed 5 of 11 client files which were found to be well organized and contained all the required documentation. Care plans were current in files reviewed.
Staff files contained the required documentation of completed training and first aid/CPR certification.
Smoke detectors, carbon monoxide detectors were operational and facility has fire sprinklers throughout.
Fire extinguishers were charged and current.

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: 02/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2025
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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