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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 397004527
Report Date: 02/15/2023
Date Signed: 02/15/2023 11:20:07 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 02/15/2023 11:20 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:BETHANY ADULT DAY CAREFACILITY NUMBER:
397004527
ADMINISTRATOR:SMITH, SHANNONFACILITY TYPE:
775
ADDRESS:1010 WEST 2ND STREETTELEPHONE:
(209) 599-7670
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY: 12CENSUS: 0DATE:
02/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jose VenturaTIME COMPLETED:
11:30 AM
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On 2/15/23 at approximately 10am Licensing Program Analyst (LPA) Maja Jensen arrived at facility unannounced to conduct a required 1 year annual inspection. LPA Maja Jensen met with Jose Ventura and explained the purpose of today's visit. The facility closed for COVID and has not yet re-opened. The facility may re-open in March 2023 if there is sufficient clientele.

LPA Jensen toured the facility including grounds, kitchen, bathrooms, and activity rooms. The grounds were observed to be maintained and all paths were free of obstruction. There are no bodies of water on the property. LPA Jensen observed sufficient space and outdoor furniture for activities.

The interior was observed to sanitary. There was sufficient lighting and furniture observed throughout. The water temperature in the bathroom was within the required regulatory range of 105-120 degrees. The bathrooms were observed to be equipped with grab bars at the toilet and in the shower. There was non-slip flooring observed in the shower. The facility has a variety of activities available for participant engagement.

The smoke detectors and carbon monoxide detectors were tested and found to be in working order. The fire extinguisher was last serviced on May 2, 2022 and is in compliance. Chemical supplies were observed to be stored in closet that is equipped with a lock. The facility maintains a 30 day supply of PPE. The first aid kit was observed to be complete.

The facility was found to be in substantial compliance. No deficiencies were cited as a result of this visit.
An exit interview was conducted and a copy of this report was given.
SUPERVISORS NAME: Liza King
LICENSING EVALUATOR NAME: Maja Jensen
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2023
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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