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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803543
Report Date: 02/11/2022
Date Signed: 02/11/2022 02:35:03 PM

Document Has Been Signed on 02/11/2022 02:35 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:INCLUSION SPECIALIZED PROGRAMS LLC - WHISPERGLENFACILITY NUMBER:
486803543
ADMINISTRATOR:BALDWIN, VANESSAFACILITY TYPE:
735
ADDRESS:630 WHISPERGLEN CTTELEPHONE:
(562) 447-0991
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 4CENSUS: 2DATE:
02/11/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:11 AM
MET WITH:Vanessa Baldwin, AdministratorTIME COMPLETED:
01:55 PM
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Licensing Program Analyst (LPA) Walters conducted a case management regarding two incidents that occurred at the facility on 1/26/22 and 2/4/22. LPA met with Administrator, Vanessa Baldwin. A Case management is being conducted to gather more information regarding the facilities safeguarding procedures and to interview staff.

Incident occuring on 1/26/22 Community Care Licensing received a report from this facility indicating that client's personal and incidental (P & I) funds were missing. After learning this, the Administrator contacted the Vacaville Police Department who took an incident report. Facility submitted a claim and had the clients P & I money refunded to them. While at the facility LPA reviewed the facilities procedures for safeguarding medication, and audited the P & I funds. In addition LPA interviewed staff and reviewed records. This incident will require additional review.

Incident occurring on 2/4/22 Community Care Licensing received a SOC 341 report from this facility indicating alleged physical abuse. While at the facility LPA conducted interviews, gathered additional documents. This incident will also require additional review.

No deficiencies cited during today's visit.
SUPERVISORS NAME: Hope DeBenedetti
LICENSING EVALUATOR NAME: Katrina Walters
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2022
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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