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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 345002915
Report Date: 09/11/2024
Date Signed: 09/11/2024 01:15:20 PM

Document Has Been Signed on 09/11/2024 01:15 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:RCCA COMMUNITY ACCESS PROGRAMFACILITY NUMBER:
345002915
ADMINISTRATOR/
DIRECTOR:
ELSTON, SHARRAEFACILITY TYPE:
775
ADDRESS:4980 WATT AVENUE SUITE CTELEPHONE:
(530) 933-1590
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY: 43CENSUS: 28DATE:
09/11/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:03 AM
MET WITH:Clara Roberts, Assistant ManagerTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On September 11, 2024, Licensing Program Analyst (LPA) DeAnna Williams-Lyons arrived unannounced to conduct an Annual Inspection. LPA met with Clara Roberts, Assistant Manager, who assisted in today's inspection. The facilities capacity is 43. The facilities Emergency Disaster Plan, Resident’s Rights and Facility Sketch were available for viewing. The room temperature was 72 degrees F which is within range.

This is an Alta funded specialized program that accommodates physically and mentally disabled clients. LPA inspected the interior of the facility including the common spaces, Multi purpose rooms and bathrooms, activity/exercise rooms, group conference rooms, and the kitchen. In the kitchen area, cabinets and drawers were reviewed. Knives and sharp objects were reviewed to make sure that they were locked and made inaccessible to the residents at all times. There’s appropriate lighting throughout the facility.
Smoke alarms were in good working order. Fire extinguisher is ready for emergency use and the first aid kit was found to be complete.

LPA reviewed 4 resident record and 3 staff records. Resident files were found to be complete and current. A review of staff records indicates that facility staff have received criminal record clearances and/or are associated to this facility. Staff records reviewed indicated current first aid certificates and the Facility is conducting staff training as required.



In the areas that were evaluated, no deficiencies were observed.
Per California Code of Regulations, Title 22, no citations were issued.

An exit interview was conducted and a copy of this report was given to Clara.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: DeAnna Williams-Lyons
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/11/2024
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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