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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 347005635
Report Date: 08/01/2024
Date Signed: 08/01/2024 01:10:33 PM

Document Has Been Signed on 08/01/2024 01:10 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 SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:VISIONS IN MOTION ADULT DAY PROGRAM, INC.FACILITY NUMBER:
347005635
ADMINISTRATOR/
DIRECTOR:		JULIE AGCAOILIFACILITY TYPE:
775
ADDRESS:8929 EMERALD PARK DRIVETELEPHONE:
(916) 627-1704
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 48CENSUS: DATE:
08/01/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:35 AM
MET WITH:Julie Agcaoili and Shirley LewisTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
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On 8/1/24, Licensing Program Analyst (LPA) Arvin Villanueva arrived unannounced to this facility to conduct a case management visit to follow up on an incident report submitted to the Department on 6/17/24. LPA met with Julie Agcaoili (ADM1) and Shirley Lewis (ADM2) and explained the purpose of the visit.

Incident Overview: On 6/17/24, ADM1 received a report from client C1 alleging inappropriate physical contact by client C2. C2 admitted to the act of inappropriate touching. ADM1 immediately contacted Alta California Regional Center ACRC), the local Police Department and Adult Protective Services (APS) to file a formal report on the same day as procedure. Note that these incidents occurred during transportation.

Additional Information: On June 19, 2024, another client, C3, reported to ADM1 and ADM2 that they had witnessed C2 touching C1 inappropriately on multiple occasions. This additional information prompted ADM1 and ADM2 to consult with Alta California Regional Center (ACRC) representatives to determine the appropriate next steps for addressing the situation.

Background on Involved Parties: Interviews with ADM1 and ADM2 revealed that C2 has a history of inappropriate sexual behavior as reported by other family members, primarily involving text messaging and/or social media interactions. The physical act of inappropriate touching reported in this incident was new information to them. It was noted that C2 had previously attended classes on healthy relationships, and all involved parties were aware of C2’s behavioral history.

Documentation Review: During the visit, the Licensing Program Analyst (LPA) reviewed the client files for C1 and C2, including their annual Individual Service Plan (ISP) and Individual Program Plan (IPP). The review indicated that C2 did not have a documented history of inappropriate physical contact.

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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: VISIONS IN MOTION ADULT DAY PROGRAM, INC.
FACILITY NUMBER: 347005635
VISIT DATE: 08/01/2024
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Follow-Up Actions: Facility had coordinated with local law enforcement and APS to ensure a thorough investigation and appropriate action were taken. Facility has also coordinated with ACRC representatives to determine and try to implement appropriate interventions and safeguards for involved clients. Through interviews, facility will continue to provide necessary support services to all their clients including emotional support to address the impact of the incidents. Reporting requirements to the Department was done in a timely manner.

Per California Code of Regulations, Title 22 no deficiencies were observed or cited during today's case management inspection.

An exit interview with Julie and Shirley was conducted and a copy of this report was provided.




















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SUPERVISORS NAME: Stephen Richardson
LICENSING EVALUATOR NAME: Arvin Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
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