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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 325000770
Report Date: 06/13/2024
Date Signed: 06/13/2024 04:41:13 PM

Document Has Been Signed on 06/13/2024 04:41 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
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ALIVEFACILITY NUMBER:
325000770
ADMINISTRATOR/
DIRECTOR:
MCELWAIN, MARYFACILITY TYPE:
775
ADDRESS:112 BUCHANAN STTELEPHONE:
(530) 283-0111
CITY:QUINCYSTATE: CAZIP CODE:
95971
CAPACITY: 30CENSUS: 10DATE:
06/13/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:14 AM
MET WITH:Mary McElwain -administratorTIME VISIT/
INSPECTION COMPLETED:
01:00 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
06/13/2024 11:15 AM Licensing Program Analyst (LPA) Rebecca Knight arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with administrator Mary McElwain and explained the purpose of the visit.

LPA Knight and the administrator toured the facility together to ensure the health and safety of clients who attend program. Areas toured include but are not limited to common areas, two (2) bathrooms, kitchen, storage areas and back yard. Staff and resident files were reviewed. All employees requiring background checks are cleared.

There is a schedule of recreational activities planned for the clients. The facility runs a recycling program that the clients can participate in if they chose to do so. Funds are placed into a client activities account and clients can use the money as they chose including participating in an annual group summer trip. Any recyclable materials that are collected are temporarily stored in an out building and taken to the local recycling center weekly.

The facility was observed to be at a comfortable temperature. Common area was clean and in good repair. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Fire extinguishers fully charged and were inspected in July 2023. No pools/bodies of water are on premises. Last disaster drill was conducted in May 2024 which was a fire drill, the facility has been conducting fire drills monthly. Facility has also been providing safety training to the clients including fire safety, earthquake safety and general safety.

LPA requested the following documents in order to update the facility file:
LIC500 Personnel Report

In the areas toured no immediate health, safety, or personal rights violations were observed. No deficiencies are being cited as a result of today’s inspection.

Exit interview conducted and copy of report was provided to administrator Mary McElwain.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Rebecca Knight
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2024
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