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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496801313
Report Date: 03/19/2025
Date Signed: 03/19/2025 01:07:27 PM

Document Has Been Signed on 03/19/2025 01:07 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
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:SARAH'S YOUNG ADULT HOMEFACILITY NUMBER:
496801313
ADMINISTRATOR/
DIRECTOR:
GREGORI, LINDSEYFACILITY TYPE:
735
ADDRESS:1520 GRIFFIN WAYTELEPHONE:
(707) 585-6223
CITY:ROHNERT PARKSTATE: CAZIP CODE:
94928
CAPACITY: 6CENSUS: 4DATE:
03/19/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Lindsey Gregori-AdministratorTIME VISIT/
INSPECTION COMPLETED:
01:20 PM
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Licensing Program Analyst (LPA) Alviso arrived to conduct a Required - 1 Year visit, on 3/19/25 at approximately 9:50am, and met with Administrator Lindsey Gregori.

Facility has an approved fire clearance for six (6) ambulatory only. Facility currently has four (4) clients in care. The clients all attend day program; Clients were not at the facility during the inspection.
Facility has a required emergency disaster plan. Facility has a required infection control plan.

LPA reviewed four (4) client files. All files were complete. Administrator handles P&I cash for three clients only. P&I client cash funds were accurate and records completed as required. P&I funds were locked and secured as required.
LPA reviewed three (3) staff files. Administrator Lindsey has a current administrator certificate, #6017082735, expires 5/27/26. All staff have criminal record clearance as required. Staff have required training; Staff have required first aid certification and CPR certification.

The LPA toured the facility with the Administrator. Hot water was checked at 120. degrees Fahrenheit; Administrator will ensure the hot water is no higher than 120. degrees and no lower than 105. degrees Fahrenheit. All exits were clear and unobstructed. Fire extinguishers, two (2), were fully charged. Carbon monoxide detector worked properly during the inspection. Smoke alarms worked properly during the inspection. Food supply was sufficient. There was sufficient supply of cleaners/disinfectants, paper products, hygiene products, and personal protective equipment (PPE) for use as needed/required. Facility was at a comfortable temperature during the inspection. Medications were locked and secured as required. Cleaners/disinfectants were locked and secured as required. Knives and other miscellaneous items were locked and secured as required.

There were no deficiencies cited during today's inspection.
Exit interview was conducted with Administrator.
SUPERVISORS NAME: Bethany Moellers
LICENSING EVALUATOR NAME: Dina Alviso
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2025
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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