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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 480110069
Report Date: 10/29/2024
Date Signed: 10/29/2024 02:25:47 PM

Document Has Been Signed on 10/29/2024 02:25 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:SOLANO DIVERSIFIED SERVICES, INC.FACILITY NUMBER:
480110069
ADMINISTRATOR/
DIRECTOR:
LOUIS CHIOFALOFACILITY TYPE:
775
ADDRESS:1761 BROADWAY, SUITE 135TELEPHONE:
(707) 552-0300
CITY:VALLEJOSTATE: CAZIP CODE:
94589
CAPACITY: 65CENSUS: 35DATE:
10/29/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:54 PM
MET WITH:Nick Payne (Program Manager)TIME VISIT/
INSPECTION COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Cuadra arrived unannounced to conduct an Annual Required inspection and was greeted by administrator, Nick Paine. Day Program is open Monday through Friday 8am-2:30pm.

LPA/Administrator initiated a tour of the buildings and grounds at approximately 2:00 pm and made the following observations: There were 35 participants at the facility during the inspection. Facility was a comfortable temperature and passageways were free from obstructions. Bathrooms used by participants were sanitary and in good repair. Water temperature in the bathrooms used by participants read at 117.9, which are within regulation of 105 and 120 degrees F. Toxins are located in the kitchen cabinet which was locked at the time of inspection. Participants bring their own lunch and those who stay at the facility during the day eat in varies activity rooms. Refrigerators for participant were clean and in good repair. Transportation services are provided to some participants by R&D vendor. LPA was able to check the van, it has current fire extinguisher and first aid kit was present. Fire extinguisher was last inspected July 2024. Facility has a centralized smoke alarm system that is maintained by a vendor. Carbon monoxide was tested and operational. Last disaster drill was conducted on 9/6/24

During today's visit, LPA only conducted physical plant with Administrator due to day Program was about to close for the day and LPA was unable to conduct file review of participants and staff. LPA will return to conduct file review at a different time.

No deficiencies cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Exit interview was conducted with Administrator and a copy of this report was given.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Marisol Cuadra
LICENSING EVALUATOR SIGNATURE: DATE: 10/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2024
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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