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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 236803786
Report Date: 12/27/2024
Date Signed: 12/27/2024 10:47:49 AM

Document Has Been Signed on 12/27/2024 10:47 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:COMMUNITY CONNECTION 2, THEFACILITY NUMBER:
236803786
ADMINISTRATOR/
DIRECTOR:
AVILA, FRANKIEFACILITY TYPE:
775
ADDRESS:365 CYPRESS STREETTELEPHONE:
(707) 964-4940
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY: 15CENSUS: 1DATE:
12/27/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Adam AshfordTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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At approximately 8:30AM, Licensing Program Analyst (LPA) Chris Arnhold arrived unannounced at this Licensed Day Program to conduct an Annual Required Inspection. LPA met with Program Director Adam Ashford and Program Manager Frankie Avila and Safety Officer Kelly Smith and toured the facility and reviewed records. This Day Program operates Monday -Friday. There was 1 Client and 4 Staff present at the time of this inspection. The facility consists of an office, two large activity rooms, a quiet room, a kitchen, and two bathrooms. LPA observed the facility was a comfortable temperature and found all exits and walkways to be unobstructed. Fire extinguishers were charged. Smoke detector was operational and Carbon monoxide detector was present. The facility grounds were also kept clean and without hazards. Clients bring lunches but there are snacks available for clients.
Toxins are centrally stored and secure. Water temperature measured within regulation between 105 and 120 degrees at faucets accessible to clients. Client money is not handled by facility. Day Program staff receive resident medication daily from home staff, and ensure the medication is stored securely. Clients do crafts and other activities while at program. At approximately 9:00AM, LPA reviewed 5 client files and found files to be thorough and contain current client care assessments and individualized Service Plans. Staff records were also found to be current, including staff first aid and CPR training verification. Disaster drills are conducted monthly.

No deficiencies were found in the areas inspected, No citations issued during today’s visit.

SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Christopher Arnhold
LICENSING EVALUATOR SIGNATURE: DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/27/2024
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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