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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 507001405
Report Date: 01/26/2023
Date Signed: 01/31/2023 10:32:04 AM

Document Has Been Signed on 01/31/2023 10:32 AM - 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, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME:CENTRAL VALLEY TRAINING CENTER, INC.FACILITY NUMBER:
507001405
ADMINISTRATOR:MARY VELAZQUEZFACILITY TYPE:
775
ADDRESS:1405 KANSAS AVENUE, SUITE CTELEPHONE:
(209) 522-0332
CITY:MODESTOSTATE: CAZIP CODE:
95351
CAPACITY: 126CENSUS: 63DATE:
01/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mary VelazquezTIME COMPLETED:
12:00 PM
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Unannounced annual visit made out to this day program on 01/26/2023 by Licensing Program Analysts (LPAs) Charlie Yang and Kimberly Viarella who were met by the facility designated Administrator Mary Velazquez. Brief interview was conducted with the facility designated Administrator.
It was learned that this day program was vendorized through Valley Mountain Regional Center and maintained a 3:1 client to staff ratio at all times.
Current census was 63 clients.
Tour of this day program was conducted.
Office areas and rooms intended for staff use were toured. Furniture and furnishings were observed to be sufficient to meet the needs of the staff and facility personnel at this time.
Tour of the facility classrooms was conducted. Different sessions and skills were individually taking place during the course of this tour for all day program participants. It was observed that staffing was sufficient to meet the ratio requirements. Supplies and resources were observed to be sufficient to meet the needs of the clients at this time.
A tour of the facility restrooms was conducted. Hot water temperatures were taken to make sure that they were within the allowed range of 105-120 degrees at all times.
Fire extinguishers, located throughout this facility, were observed to have been annually inspected on 12/01/2022 by the local fire extinguisher company, Nor Cal Fire, Inc, and observed to be in compliance at this time.
Kitchen area was toured. It was learned that classes were held to teach cooking, baking, and life skills. Equipment was observed to be sufficient to meet the needs of the clients at this time. Food storage units were observed to be present and in good repair at this time.
Closets housing bleach, detergent, and all other cleaning supplies were observed to be locked and made inaccessible to the clients at this time.
First aid kits were observed to be present and did contain all of the required components at this time.
A tour of the exterior garden class set up was conducted. It was observed that there was a greenhouse
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.270
SACRAMENTO, CA 95833
FACILITY NAME: CENTRAL VALLEY TRAINING CENTER, INC.
FACILITY NUMBER: 507001405
VISIT DATE: 01/26/2023
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and equipment made available to teach clients about growing and maintaining several types of plants and vegetables.
This facility did not have a perimeter fence or side gates except for the back fence area surrounding the garden section. It was observed to be maintained in good repair at this time.

The following forms and documents were requested to be updated and submitted into CCL for review by this LPA:

LIC 308

LIC 400

LIC 500

LIC 610

There were no deficiencies observed or cited during todays annual visit.

Exit Interview
SUPERVISORS NAME: Stephenie Doub
LICENSING EVALUATOR NAME: Charlie Yang
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
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