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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486800885
Report Date: 07/14/2022
Date Signed: 07/14/2022 10:58:15 AM

Document Has Been Signed on 07/14/2022 10:58 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:ARC-SOLANO, THEFACILITY NUMBER:
486800885
ADMINISTRATOR:STACEY MARTINEZFACILITY TYPE:
775
ADDRESS:3272 SONOMA BLVD #4TELEPHONE:
(707) 552-2935
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY: 30CENSUS: 11DATE:
07/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Marianita Vieira, Director of ServicesTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Tobola conducted an unannounced Annual Required – 1 yr. Infection Control inspection for this facility and met with Program Coordinator, Tamara Huizen and Director of Services, Marianita Vieira. Director, Stacey Martinez was on an outing with a client at the time of visit and was notified. The facility is licensed by Alternatives In Curriculum & Training and currently serves 25 clients, 11 of which were at the facility at the time of visit. The facility is currently conducting a hybrid service program in which 25 clients are split between Monday through Thursday with Zoom classes offered on Fridays and for clients not served in person. Clients appear to be engaged in group activities with proper social distancing in place. LPA was informed of online remote courses provided to clients. Clients currently provide their own meals with group outings currently on hold. Sharps are all stored in a locked cabinet located in the kitchen. Toxins and cleaning supplies are stored in a designated cleaning locker and cleaning supply room inaccessible to clients.

LPA arrived at the facility and had temperature and symptoms checked and logged at the main entrance. LPA continued with a tour of the facility with staff; facility was found to be clean and at a comfortable temperature with all exits free from obstruction. Facility staff measure water temperature at faucets accessible to clients in kitchen and restrooms on a regular basis and is recorded. Fire Extinguishers were found to be last charged on 4/12/2022. Fire alarm, smoke detector and carbon monoxide detectors are interconnected and last inspected on 2/2/2021. The fire alarm system is also monitored remotely by Bay Alarm Co with a next re-certification date of 2/2/2025.

Infection Control:
Facility has submitted COVID Infection Control Plan for review. Posters have been placed at the main entrance, classrooms and restrooms with proper COVID mitigation protocols. Facility has a station at main entrance with a sign in sheet in place, hand sanitizer and other items designated for visitors and staff. Staff and clients are screened on a daily basis before they participate in program.

Continued onto LIC809-C
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: ARC-SOLANO, THE
FACILITY NUMBER: 486800885
VISIT DATE: 07/14/2022
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LPA requested the following updated documents be sent to CCL by COB 7/21/2022:

LIC 308 Designated Facility Responsibility
LIC 500 Personnel Summary
LIC 610 Emergency Disaster Plan
LIC 9020 Register of Facility Client’s/Resident’s

No deficiencies cited during today's visit.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2022
LIC809 (FAS) - (06/04)
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