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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486803806
Report Date: 08/04/2021
Date Signed: 08/04/2021 10:29:29 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:VILLAGE AT RANCHO SOLANO ASSISTED LIVING, THEFACILITY NUMBER:
486803806
ADMINISTRATOR:HALL, JAMESFACILITY TYPE:
740
ADDRESS:3350 CHERRY HILLS COURTTELEPHONE:
(707) 425-3588
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:250CENSUS: 135DATE:
08/04/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Noma MalikTIME COMPLETED:
10:45 AM
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At approximately 9:00AM, Licensing Program Analyst (LPA) Chris Arnhold arrived at this facility, unannounced, to conduct a case management visit to inspect completed renovations at the facility. LPA met with Executive Director Noma Malik and toured the second floor of the building. This section of the building was formally used as assisted living apartments and was converted to provide memory care support. LPA inspected each room. There were 8 of 26 rooms that will require additional time to complete, but can be secured from resident access. Water temperature was tested and found to be within regulation, between 105 and 120 degrees F. There was a carbon monoxide detector in each resident room, which were tested and in working order. The rooms did not contain the required furnishings, but facility has them available if the resident does not provide their own. The fire sprinkler system was being inspected for its annual inspection during this visit. This section of the building has been approved for delayed egress by the Fire Marshal. A fire Clearance has been received. Facility has a main kitchen that provides food for the building.
This renovated section is ready for resident use.

No citations issued.
SUPERVISOR'S NAME: Bethany MoellersTELEPHONE: (707) 588-5040
LICENSING EVALUATOR NAME: Christopher ArnholdTELEPHONE: (707) 588-5084
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2021
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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