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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 297000435
Report Date: 11/30/2023
Date Signed: 11/30/2023 10:40:29 AM

Document Has Been Signed on 11/30/2023 10:40 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:NEIGHBORHOOD CENTER OF THE ARTSFACILITY NUMBER:
297000435
ADMINISTRATOR:AMEE MEDEIROSFACILITY TYPE:
775
ADDRESS:200 LITTON DR. STE. 212TELEPHONE:
(530) 272-7287
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95945
CAPACITY: 75CENSUS: DATE:
11/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Amee MedeirosTIME COMPLETED:
10:50 AM
NARRATIVE
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LPA Hiratsuka arrived at 10am and conducted this unannounced annual visit. LPA toured with Amee Medeiros, Executive Director. The main entrance to the program is from an outside staircase located when facing the front of the building to the left and back part of the building the program rents space from. The main entrance opens to a large common area. To the left there are several small rooms that are used as offices and a quiet area. To the right leads to several more rooms that are connected to the large, long common area. All the rooms are used for art projects. There is one room used for woodworking that is locked when not in use. There's a kitchenette area. There are two restrooms for the clients. This program provides art supplies to the clients so the clients can produce the artwork. There is also an outside area the clients are able to use as a garden. The garden area is fenced in.

-several client files were reviewed.
-several staff files were reviewed.
-multiple topics were reviewed during this visit

No deficiencies cited
SUPERVISORS NAME: Troy Ordonez
LICENSING EVALUATOR NAME: Kerry Hiratsuka
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2023
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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