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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002915
Report Date: 06/22/2023
Date Signed: 06/22/2023 10:24:25 AM

Document Has Been Signed on 06/22/2023 10:24 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:RCCA COMMUNITY ACCESS PROGRAMFACILITY NUMBER:
345002915
ADMINISTRATOR:GOMEZ, BRENDAFACILITY TYPE:
775
ADDRESS:4980 WATT AVENUE SUITE BTELEPHONE:
(530) 933-1590
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 43CENSUS: 36DATE:
06/22/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Les Parker, VP, West RegionTIME COMPLETED:
10:38 AM
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On June 22, 2023 at 9am, Licensing Program Analyst (LPA) DeAnna Williams-Lyons made an announced visit to conduct the Pre-Licensing inspection. LPA met with Les Parker, VP of West Region, Sharrae Elston, Executive Director and Program Manager, Mane Bermingham. This is an Adult Day Program. The programs capacity is 40. Currently, their census is 36. The program has not relocated yet but is expected to relocate sometime in August 2023. The program requested approval of the space they will be occupying.

LPA inspected the interior and exterior of the facility. There will be common spaces, client activity/class rooms, training rooms, a quiet room, bathrooms and kitchen. The 3 Bathrooms were clean and had all the necessary components. Hot water temperature will be check during the Post Inspection. Smoke alarms and Fire extinguishes were installed and will be checked during the Post Inspection The alarm system is connected to an alarm company and is checked and tested quarterly. There’s appropriate lighting throughout the facility.

The kitchen will have a microwave, refrigerator, and sink. There will also be a place for the clients to eat. The is a back parking lot that will house the transportation and will have a covered patio area. There are no bodies of water on the premises. The facility was observed to have been inspected on 6/16/2023 by Fire Code and in compliance at this time. The Program's intent is to be fully moved in, in August 2023. LPA will return for a Post Inspection to ensure compliance with Title 22 Regulations.

During this Pre -Inspection no violations were observed.

An exit interview was conducted and a copy of this report was given to Les Parker.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons
LICENSING EVALUATOR SIGNATURE: DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2023
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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