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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 390308140
Report Date: 02/22/2023
Date Signed: 02/22/2023 11:46:59 AM

Document Has Been Signed on 02/22/2023 11:46 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:CENTRAL VALLEY TRAINING CENTER, INC.FACILITY NUMBER:
390308140
ADMINISTRATOR:RAYMOND NYLENFACILITY TYPE:
775
ADDRESS:7603 MURRAY DRIVETELEPHONE:
(209) 951-1504
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY: 90CENSUS: 64DATE:
02/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:16 AM
MET WITH:Michael CarrollTIME COMPLETED:
11:50 AM
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On 2/22/23 at 10:16am, Licensing Program Analyst (LPA) Michael Bilger arrived at this facility unannounced to conduct an annual inspection visit. LPA met with the Program Director Michael Carroll and explained the purpose of the visit.

LPA Bilger inspected the physical plant including but not limited to the kitchen area, client classrooms, client bathrooms, laundry room, changing room, and outside area of the facility to ensure compliance with Title 22 regulations. Facility is an adult day program with a current census of 64. Facility has 5 classrooms, 5 are currently in use. All staff and clients were wearing masks. LPA was screened upon entry for temperature and symptoms. LPA conducted COVID-19 screening questions. No active COVID-19 within facility at this time. LPA also conducted the infection control domain tool. Facility conducts staff training for COVID-19 precautions which was verified by LPA.
The facility submitted a LIC 808 mitigation plan, which was approved. The facility has central entry point and has implemented screening and sign in procedures at the front door area. The facility conducts routine symptom screening for employees, clients, and visitors when necessary. LPA observed the facility to have hand washing, COVID - 19 informational, and social distancing signs posted throughout the facility, on the front door, and outside. The facility has a designated infection control lead. The facility is able to designate and dedicated a Covid-19 room/bathroom if needed. Common touch surfaces are cleaned after each use. Facility maintains 30-day supply of PPE accessible to staff as necessary. LPA reviewed 5 staff charts. All first aid/CPR and COVID-19 vaccinations current. 2 staff have religious exemptions verified.
Water temperature reads 105*F to 120*F in the bathroom and room temperature read 68*F. Client classrooms were sanitary and had the required furniture and furnishings. The facility common areas were clean and furnished. Smoke and carbon detectors were in good repair. Fire extinguisher was checked 1/3/23.

Per California Code of Regulations, Title 22, no deficiencies were observed during this visit. Exit interview was held and a report was given to Program Director Michael Carroll.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Michael Bilger
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
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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