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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 486804139
Report Date: 07/17/2024
Date Signed: 07/17/2024 12:17:55 PM

Document Has Been Signed on 07/17/2024 12:17 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: 21DATE:
07/17/2024
TYPE OF VISIT:OfficeUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Wendi Counta, Acting Administrator & Katrina Brass, Quality Improvement DirectorTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
NARRATIVE
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On 7/17/2024, a formal office meeting was conducted in the Santa Rosa Regional Office. Present in the meeting were Licensing Regional Manager, Carla Nuti-Martinez, Licensing Program Manager, Kim Mota, Licensing Program Analyst, Dominic Tobola, Acting Administrator, Wendi Counta and Quality Improvement Director, Katrina Brass.

The purpose of the informal conference was explained to the Licensee/Administrator discussing facility compliance for the following areas:
- Drugs bought and sold in facility
- Reporting Requirements
- Administrator Qualifications

Citation issued under regulation 80064(a)(2) for Administrator Qualifications & Duties, pertaining to prior Administrator. The Licensee has hired a new Program Director/Administrator who agrees to ensure compliance moving forward. Deficiency was cleared at the time of visit. Licensee/Administrator has agreed to receive Technical Support Program (TSP). TSP referral will be submitted by the Regional Office.

Licensee will also look into separating the two buildings on property and re-license one building as a Social Rehabilitation Facility while the other remains as an Adult Residential Facility. A new application will be submitted for a Social Rehabilitation Facility should this work with their County contract.

Deficiency cited from the California Code of Regulations, Title 22, Division 6 of California Regulation. Appeal rights given. Failure to correct the deficiency and/or repeat deficiencies within a 12-month period may result in civil penalties.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Dominic Tobola
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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Document Has Been Signed on 07/17/2024 12:17 PM - It Cannot Be Edited


Created By: Dominic Tobola On 07/17/2024 at 11:37 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: SOLANO HOUSE
FACILITY NUMBER: 486804139

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/17/2024
Section Cited
CCR
80064(a)(2)

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80064 Administrator - Qualifications and Duties (a) The administrator shall have the following qualifications:
(2) Knowledge of the requirements for providing the type of care and supervision needed by clients... This requirement was not met as evidenced by:
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Licensee has hired a new Program Director/Administrator and in combination with Quality Improvement Director will ensure regulations for Administrator Qualifications and Duties are met for providing care and supervision needed by clients. Deficiency cleared at time of visit.
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Prior Administrator did not ensure proper actions were taken in providing care and supervision for clients in care due to drugs being bought and sold in the facility.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Kimberley Mota
LICENSING EVALUATOR NAME:Dominic Tobola
LICENSING EVALUATOR SIGNATURE:
DATE: 07/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/17/2024


LIC809 (FAS) - (06/04)
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