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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 496803398
Report Date: 02/04/2025
Date Signed: 02/04/2025 12:57:25 PM

Document Has Been Signed on 02/04/2025 12:57 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:PROGRESS FOUNDATION-PARKER HILL PLACEFACILITY NUMBER:
496803398
ADMINISTRATOR/
DIRECTOR:		LONG, MATTHEWFACILITY TYPE:
772
ADDRESS:3371 PARKER HILL ROADTELEPHONE:
(707) 535-0289
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY: 12CENSUS: 10DATE:
02/04/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Matthew Long, Administrator/Program DirectorTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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At approximately 9:05 AM, Licensing Program Analyst (LPA) Robert Frank arrived unannounced to conduct a 1-Year Required Visit and was greeted by Program Director (PD), Matthew Long. The facility provides social rehabilitation for adults. Facility is a single story ranch house with a detached garage. There are several outside seating areas and a small pond which is secured behind a wooden fence. Facility has an approved fire clearance for twelve (12) ambulatory clients. Upon arrival, LPA was informed that there were ten (10) clients in care and four (4) staff members on-site. At approximately 9:30 AM, LPA reviewed the Facility's Staff Roster and found that all staff on-site were background cleared and associated to the facility per regulation.

At approximately 10:00 AM, LPA toured the facility with PD Long. All exits were clear and unobstructed. All three (3) fire extinguishers were last serviced and tagged in July, 2024. Fire Department inspected and cleared the fire alarm system in July, 2024. Food supply was sufficient. During Inspection, LPA observed two (2) cans of food that had expired. A Technical Violation was issued for the two (2) cans of food that had expired. The facility was sufficiently lighted and Furnished. LPA inspected three (3) client bedrooms and found all to have sufficient lighting and furnishings as required per Title 22 Regulations. There was a sufficient supply of both perishable and nonperishable foods as required by Title 22 Regulations. There was an appropriate supply of cleaning products, linens, hygiene products and paper products available for clients. Toxins were observed to be stored inaccessible to clients. Facility has an infection control plan as required. The facility has a required emergency disaster plan. The facility is conducting fire and emergency drills monthly. The last disaster drill was conducted on 1/23/2025. The facility does have emergency food and supplies to meet the "72 hour shelter in place" requirements. Hot water temperatures for all sinks in facility were found to be within Title 22 regulations of 105 to 120 degrees Fahrenheit. Facility smoke detectors and carbon monoxide detectors were tested and operational.



Continued on 809-C...
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE: DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: PROGRESS FOUNDATION-PARKER HILL PLACE
FACILITY NUMBER: 496803398
VISIT DATE: 02/04/2025
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...Continued from 809

At approximately 11:00 AM, LPA reviewed five (5) client files. Five (5) of five (5) client files were found to be well organized and thorough with all required documentation. LPA reviewed five (5) staff files. All staff files were found to be well organized with all required documentation including First Aid and CPR certification and proper training documentation. LPA spot checked Medication for three (3) clients. LPA observed all medications to be centrally stored, secure and with proper documentation. The facility does not handle client monies for personal and incidental items.

LPA requested the following documents be submitted to Community Care Licensing by 3/5/2025:

LIC 500 Personnel Report
LIC 308 Designation of ResponsibilityL
LIC 610D Emergency Disaster Plan
LIC 309 Administrative Organization

No deficiencies cited during today's visit. Exit interview conducted. Copy of report and LIC 9102 (Technical Violation/Advisory) discussed and provided to Administrator. Signature on form confirms receipt of documents.
SUPERVISORS NAME: Victoria Bertozzi
LICENSING EVALUATOR NAME: Robert Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 02/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025
LIC809 (FAS) - (06/04)
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