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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005635
Report Date: 02/07/2023
Date Signed: 02/07/2023 10:27:26 AM

Document Has Been Signed on 02/07/2023 10:27 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:VISIONS IN MOTION ADULT DAY PROGRAM, INC.FACILITY NUMBER:
347005635
ADMINISTRATOR:JULIE AGCAOILIFACILITY TYPE:
775
ADDRESS:8929 EMERALD PARK DRIVETELEPHONE:
(916) 627-1704
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 48CENSUS: 16DATE:
02/07/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Julie AgcaoiliTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Christina Valerio arrived unannounced to the day program to conduct an annual visit. LPA met with Administrator Julie Agcaoili, and explained the purpose of the visit.

The day program currently has active COVID cases. The facility has been following their infection control plan, has had communication with public health, and has been in communication with LPA regarding positive cases. The facility common areas is observed to be clean, organized, and free from debris. Staff are continuously cleaning, observed to be wearing the correct mask, and utilizing social distancing procedures. The facility is still utilizing the plastic dividers. Due to the current status of the Day Program, operating with in-person and remote services.

Hot water was measured at 112.5*F, which is within the regulatory range. A pull alarm fire system and fire extinguishers was observed to be in working condition.

Per California Code of Regulations, Title 22, Division 6, Chapter 8, no deficiencies were observed during this visit. An exit interview was held, and a copy of the report was given.
SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Christina Valerio
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2023
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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