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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 342700741
Report Date: 04/13/2022
Date Signed: 04/29/2022 08:45:46 AM

Document Has Been Signed on 04/29/2022 08:45 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:LEGGS RESIDENTIAL ADULT CARE IIFACILITY NUMBER:
342700741
ADMINISTRATOR:LEGGS, BRADFORD TFACILITY TYPE:
735
ADDRESS:10044 TWIN CITIES ROADTELEPHONE:
(707) 332-1262
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY: 6CENSUS: 0DATE:
04/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Bradford Leggs, AdministratorTIME COMPLETED:
02:35 PM
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On 04/13/22 at 12:30 pm, Licensing Program Analysts (LPAs) T. White and LPAs Campbell arrived unannounced to conduct a required 1-year Annual inspection. LPAs met with Administrator Bradford Leggs and Phyllis Leggs. LPAs explained the purpose of today’s inspection. LPAs were allowed entry into the facility that is licensed to serve a total capacity of 6 ambulatory clients.

LPAs toured the facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. All toilets, hand washing, and bathing are safe, sanitary and in operating condition. There is a minimum of 7-day nonperishables and 2-day perishable foods. Smoke detectors and carbon monoxide were in operating condition during inspection. Fire extinguisher was last serviced on June 16th, 2021. First aid kit observed to be complete.

- LPAs observed no clients at the facility. Administrator stated they are working with ALTA to obtain clients. LPA's informed administrator to contact CCLD once the facility admits clients.

No deficiencies cited during inspection.

Exit interview conducted with Administrator.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Treana White
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2022
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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