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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803540
Report Date: 08/03/2022
Date Signed: 08/03/2022 04:01:31 PM

Document Has Been Signed on 08/03/2022 04:01 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:PEOPLE'S CARE MORNING SUNFACILITY NUMBER:
486803540
ADMINISTRATOR:HENRY, STEPHANIEFACILITY TYPE:
735
ADDRESS:707 MORNING SUN CTTELEPHONE:
(707) 449-3935
CITY:VACAVILLESTATE: CAZIP CODE:
95688
CAPACITY: 4CENSUS: 4DATE:
08/03/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Administrator, Stephanie HenryTIME COMPLETED:
04:15 PM
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Licensing Program Analysts (LPAs), Farhaan Sarangi and Caitlynn Felias arrived unannounced at People's Care Morning Sun for the purpose of conducting a Case Management-Incident inspection regarding a SOC 341 and Special Incident Report (SIR) that was reported on August 3, 2022. LPA was greeted at the door by, Administrator, Stephanie Henry, and was granted access into the facility.

During the Case Management-Incident inspection, LPA toured the facility with the Administrator and found the facility to be clean and at a comfortable temperature with all exits free from obstruction. Water temperature measured at 115 degrees and within Title 22 regulation. LPA observed sufficient perishable and non-perishable foods.

LPAs interviewed Administrator regarding a recent self reported incident regarding a SOC 341. Facility cross reported to the local law enforcement who conducted an investigation. Facility will email the police report once it is made available. Facility has increased supervision as a precaution and have discussed consent with clients. LPAs requested the following document(s) to be emailed:

-Both client files
-Client Roster
-Most updated facility sketch
-Law Enforcement report
-LIC 500

Exit interview was conducted and a copy of this report was signed and given to the Administrator.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Farhaan Sarangi
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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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