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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700116
Report Date: 08/18/2022
Date Signed: 09/08/2022 10:19:47 AM


Document Has Been Signed on 09/08/2022 10:19 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833



FACILITY NAME:ST ANTHONY ADULT TRAINING PROGRAM 2FACILITY NUMBER:
342700116
ADMINISTRATOR:PALABAY, JOSEPHINEFACILITY TYPE:
775
ADDRESS:7171 BOWLING DRIVE SUITE 400TELEPHONE:
(916) 424-6306
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY:30CENSUS: 4DATE:
08/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Administrator Matthew Enriquez TIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jason Lund arrived at the above address unannounced to conduct an annual inspection. LPA met with program manager Krystal Corpz and explained the reason for the visit. Administrator Matthew Enriquez arrived short time later. Census 4. The day program operates with Alta Regional Center with a required ratio of 1 to 2. During today's visit, there were 4 clients present.

LPA Lund and Administrator Matthew Enriquez toured the facility both indoors and outdoors. LPA observed a large room with 4 small rooms adjacent to the large room. LPA observed another room with 2 adjacent rooms. 2 bathrooms in the back 2 rooms of the building. LPA observed an office area with 2 rooms. There is a cabinet for locked medications. There is a kitchenette area. The outside of the facility was observed to be in good repair and safe for residents. The inside of the facility was observed to be in good repair. Facility was maintained at a comfortable temperature (73). Facility storage and lighting were adequate. Chemicals and toxins were appropriately under lock and key. Facility does handle medication in a locked box with a MAR. Smoke detectors are connected to a third company who managed the building. Facility has central pull fire alarms throughout. Fire extinguishers (1/15/22) were fully charged and ready for emergency use. First aid kit was fully stocked for use.

There were no deficiencies cited during visit. Exit interview conducted with Administrator Matthew Enriquez and report left.
SUPERVISOR'S NAME: Stephenie DoubTELEPHONE: (916) 263-2131
LICENSING EVALUATOR NAME: Jason LundTELEPHONE: (916) 223-6752
LICENSING EVALUATOR SIGNATURE:
DATE: 08/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/18/2022
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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