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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 275200905
Report Date: 06/21/2022
Date Signed: 06/22/2022 11:02:32 AM

Document Has Been Signed on 06/22/2022 11:02 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,
, CA
FACILITY NAME:SOLEDAD SVSFACILITY NUMBER:
275200905
ADMINISTRATOR:DIANA CASTANEDAFACILITY TYPE:
775
ADDRESS:757 FRONT STREETTELEPHONE:
(831) 678-9431
CITY:SOLEDADSTATE: CAZIP CODE:
93960
CAPACITY: 60CENSUS: 30DATE:
06/21/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Program Director Elizabeth MolinaTIME COMPLETED:
02:45 PM
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Licensing Program Analyst (LPA) Jason Lund arrived at the above facility unannounced to conduct an Annual/Required inspection. LPA Lund met with Program Director Elizabeth Molina and explained the reason for the visit.

LPA Lund and Ms. Molina walked including the activity rooms, kitchen, exercise room, library room, computer room, movie room, game room, arts and crafts, and client storage area. This day program does not provide lunch/snacks, the clients bring their lunch and snacks to programming. P&I monies are not handled by day program. The room temperature reads at 75 degrees F. Carbon monoxide detector was observed and operational in hallway. Individual smoke and fire detectors are tested and observed working.

Disaster drills were last conducted on 5/2022. The facility restrooms were inspected and observed clean and sanitary. Staff office was observed.
None of the clients need medication during programming. First aid box was observed and deemed adequate. Three fire extinguisher were mounted and charged 8/6/2021. Facility is clean there are no hazards present and passageways are clear.

Based on today's visit there are no deficiencies cited today exit interview conducted with Program Director Elizabeth Molina.
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Jason Lund
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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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