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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486801055
Report Date: 01/17/2024
Date Signed: 01/17/2024 03:35:50 PM

Document Has Been Signed on 01/17/2024 03:35 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:TWIN RESIDENTIAL CARE HOMEFACILITY NUMBER:
486801055
ADMINISTRATOR:ALMONIA, SONIA G.FACILITY TYPE:
735
ADDRESS:129 COLERIDGE DR.TELEPHONE:
(707) 644-1961
CITY:VALLEJOSTATE: CAZIP CODE:
94591
CAPACITY: 6CENSUS: 5DATE:
01/17/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Administrator Sonia AlmoniaTIME COMPLETED:
03:45 PM
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On 01/17/2024 at 01:00 PM Licensing Program Analyst (LPA) Sarah Benson arrived at the facility unannounced to conduct an annual yearly Required inspection. LPA met with administrator name Sonia Almonia (cert #6024041735 exp. 03/24/2025) and explained the purpose of the visit. Administrator certificate is current

LPA Benson and administrator toured the facility together to ensure the health and safety of residents in care. Areas toured include but are not limited to five (5) resident rooms, common areas, two (2) bathrooms, kitchen, storage areas and back yard. In the areas toured no immediate health, safety, or personal rights violations were observed. Staff and resident files were reviewed. Medications were also reviewed. Medication is locked in a locked closet.



Common area was clean and in good repair. All bedrooms had required furniture, bedding, and lighting. Bathrooms were clean and in good repair. Kitchen was clean and in good repair. Facility has required (7) seven-day non-perishable and (2) day perishable supply of food.

The first aid kit is fully stocked and ready for emergency use. Fire extinguisher fully charged. Smoke detectors are all operational. Hot water temperature measured within required Title 22 regulations of 105 degrees F and 120 degrees F. All employees requiring background checks are cleared. All required postings are displayed within facility.

No pools/bodies of water are on premises. No firearms are on premises. Last disaster drill was conducted and documented on 10-28-23, the facility has been conducting drills every 3 months.

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



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

SUPERVISORS NAME: Lauren Crocker
LICENSING EVALUATOR NAME: Sarah Benson
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2024
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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