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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803543
Report Date: 02/21/2025
Date Signed: 02/21/2025 12:40:32 PM

Document Has Been Signed on 02/21/2025 12:40 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/
DIRECTOR:		JOSE HERNANDEZFACILITY TYPE:
735
ADDRESS:630 WHISPERGLEN CTTELEPHONE:
(562) 447-0991
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY: 4CENSUS: 3DATE:
02/21/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:53 AM
MET WITH:Patti Ambriz, Residential DirectorTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Jill Nakagawa conducted a Required 1 Year Inspection, and met with Patti Ambriz, Program Director. Administrator was off site at the time of inspection.

There were three (3) clients and five (5) staff on duty at the time of inspection, who are all First Aid/CPR certified. Facility has an approved fire clearance for four (4) non-ambulatory residents.

The facility was clean and well-organized. There was plenty of comfortable seating for residents and staff to sit and socialize. All exits were observed free from obstruction. Smoke/carbon monoxide detectors were tested and appeared to be operational. Toxins are stored inaccessible and in locked cabinets. The facility has a large sufficient supply of personal protective equipment (PPE). Postings were up and visible to all as required. There was an adequate supply of perishable and non-perishable foods. The water temperature was approximately 105 degrees F which is within regulation. Each resident's room was furnished with personal and homey touches. The facility conducted a Fire Drill for each shift on 01/20/2025. The fire extinguisher was fully charged and last serviced on 01/30/2025. The facility will be installing new flooring soon.

The outdoor area was clean and provided a safe environment for residents to relax and play. Facility provided a trampoline and bicycles and shaded areas to sit.

No deficiencies found at the time of inspection. No citations issued.
Exit interview conducted with Residential Director Patti Ambriz.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/21/2025
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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