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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803735
Report Date: 09/05/2023
Date Signed: 09/05/2023 04:06:46 PM

Document Has Been Signed on 09/05/2023 04:06 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:EQUIVENTURE DAY PROGRAMFACILITY NUMBER:
486803735
ADMINISTRATOR:DINGLASAN, CYNTHIAFACILITY TYPE:
775
ADDRESS:258 SUNSET AVE. STE. MTELEPHONE:
(707) 759-3888
CITY:SUISUN CITYSTATE: CAZIP CODE:
94585
CAPACITY: 45CENSUS: 45DATE:
09/05/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Nell Bunyi, Program ManagerTIME COMPLETED:
04:15 PM
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On 9/5/2023, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of following up on a self-reported incident occurring on 8/29/2023 and was greeted by Program Manager, Nell Bunyi (PM). The incident states an unknown individual had broken into the facility during the early morning hours prior to the start of program. PM informed LPA that the intruder had stolen the keys to the facility transportation vans and fled the scene. Police had arrived approximately within 5 minutes of the facility security alarms setting off.

No individuals have been apprehended but a police report was completed. PM and LPA toured the facility and LPA observed modifications to all of the facility entrances. Additional security plating was installed to cover door locks preventing further break-in incidents. The facility had installed the extra security measures and changed all of the vehicle keys/ignitions the same day of the incident. No additional incidents or concerns at this time.

No deficiencies cited during visit.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE: DATE: 09/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/05/2023
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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