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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455002981
Report Date: 10/17/2024
Date Signed: 10/17/2024 12:01:47 PM

Document Has Been Signed on 10/17/2024 12:01 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:IPS DAY PROGRAM #2FACILITY NUMBER:
455002981
ADMINISTRATOR/
DIRECTOR:		GOMEZ-ZUMKEHR, AMANDAFACILITY TYPE:
775
ADDRESS:2580 S BONNYVIEW RD #CTELEPHONE:
(530) 221-9025
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY: 35CENSUS: 33DATE:
10/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Feather Vcelik SupervisorTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 10/17/2024 at 9:30 AM Licensing Program Analyst (LPA) Sarah Benson arrived at the facility unannounced to conduct a Required-1 Year inspection. LPA met with Supervisor Feather Vcelik and Administrator Amanda Zumkehr and explained the purpose of the visit.

LPA Benson toured the facility with Supervisor and Administrator to ensure the health and safety of clients in care. Areas toured include but are not limited to work area, common areas, (3) three bathrooms, kitchen, storage areas and back yard. Staff and client files were review.



Common area was clean and in good repair. Kitchen was clean and in good repair. Work area was clean and in good repair. Medication is locked in a locked closet. First aid kit fully stocked and ready for emergency use. Fire extinguisher fully charged. Smoke detectors are all operational. All employees requiring background checks are cleared. There is a schedule of activities planned for the clients. All required postings are displayed within facility. The work area is clean and in good repair. The facility vehicles were inspected and are in good working order.

No pools/bodies of water are on premises. No firearms are on premises. Last disaster drill was conducted and documented on 10-10-24, the facility has been conducting drills every 6 months.

No deficiencies are being cited as a result of today’s inspection.



Exit interview conducted and copy of report was provided to administrator.

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2024
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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