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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486804139
Report Date: 05/17/2024
Date Signed: 05/17/2024 03:10:48 PM

Document Has Been Signed on 05/17/2024 03:10 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:SOLANO HOUSEFACILITY NUMBER:
486804139
ADMINISTRATOR/
DIRECTOR:
HALL, ELIZABETHFACILITY TYPE:
735
ADDRESS:2251,2261,& 2271 S WATNEY WAYTELEPHONE:
(530) 758-2160
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY: 32CENSUS: 22DATE:
05/17/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:47 PM
MET WITH:Wendi Counta, AdministratorTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 5/17/2024, Licensing Program Analyst (LPA) Tobola arrived unannounced for the purpose of following up on incident reports and a general health & safety check and was greeted by acting Administrator, Wendi Counta (AA). The facility submitted two incident reports involving staff medication errors. No side effects were observed from either client and AA appropriately contacted client medical providers for support. AA provided additional training for staff for corrective actions along with developing plans to address specific areas of concern within the medication room and medication record keeping. LPA and AA discussed plans to provide clients with education on medication along with more efficient strategies for staff to organize medication records and administration. AA is currently developing protocols for kitchen staff safety, in plans of implementing a client engaged cooking program, allowing clients to develop skills and create food menu based on preferences.

LPA and AA also briefly discussed plans for increased activities and updating the facility signal system. LPA finds that AA is implementing a plan of action to clearly addresses the areas of concern in recent incidents reported in a timely and appropriate manner.

No deficiencies cited during today's visit.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE: DATE: 05/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/17/2024
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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