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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002915
Report Date: 08/25/2023
Date Signed: 08/25/2023 11:01:35 AM

Document Has Been Signed on 08/25/2023 11:01 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 C/DTELEPHONE:
(530) 933-1590
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 43CENSUS: 0DATE:
08/25/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Sharrae Elston and Maria BerminghamTIME COMPLETED:
11:10 AM
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On 08/25/2023 at 10:00 AM, Licensing Program Analyst (LPA) Cassie Yang and Licensing Program Manager (LPM) Laura Munoz arrived to the facility to conduct a Pre-licensing inspection. LPA and LPM met with Alta California Regional Center (ACRC) representatives, Tom Kasper, and Kylee Draper. LPA, LPM and ACRC representatives met with Executive Director Sharrae Elston, and staff Maria Bermingham, and Ashley Thomas.

During today's inspection, LPA and LPM observed the facility to be under renovation as there is a current roof leak. Executive Director informed LPA and LPM there is a current work order on the leak. Additionally, LPA and LPM observed facility staff to be unboxing equipments for the facility.

LPA informed Executive Director due to the obstruction of the roof leak, LPA will return another day to complete the pre-licensing inspection. LPA provided facility her business card.

No deficiencies cited.

Exit interview conducted and a copy of the report was provided.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Cassie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2023
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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