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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547200750
Report Date: 10/04/2021
Date Signed: 10/04/2021 11:38:30 AM

Document Has Been Signed on 10/04/2021 11:38 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, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:VALLEY ADULT DAY SERVICES, INC.FACILITY NUMBER:
547200750
ADMINISTRATOR:MULLER, KAYLAFACILITY TYPE:
775
ADDRESS:227 E OAK AVENUETELEPHONE:
(559) 783-9815
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 75CENSUS: 9DATE:
10/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Laura KaylorTIME COMPLETED:
11:47 AM
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Licensing Program Analysts (LPA) M. Medina arrived unannounced to conduct an Annual Inspection - Infection Control. LPA met with Executive Director, Laura Kaylor and stated the purpose of the visit. Facility has one central entry and exit. Upon entry tot he facility, LPA observed visitor log-in/temperature check. Facility staff observed to be wearing facial coverings.

All entrances, exits, and pathways were free from obstructions. No fire clearance issues observed during today's inspection. LPA observed signs at the entrance promoting social distancing, cough/sneeze etiquette, and hand-washing. Day Program clients observed to be preparing for transportation at conclusion of program day. LPA observed reminders to wash hands in client bathrooms. Bathrooms were stocked with paper towels and liquid soap.

Day Program does not administer any medications on site. Meals are prepared on site, adequate food supply available for clients enrolled. Facility is sanitized throughout the day. All clients emergency contact information has been updated.

Transportation is available for clients enrolled.

Facility is equipped with a pull station. Carbon monoxide detector present and observed operational during today's inspection. Fire extinguishers present throughout the building with a service date of 6/16/2021.

No deficiencies observed during this inspection.

Program Supervisor. As a COVID-19 precautionary measure, a copy of this report will be provided via email.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Melinda Medina
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2021
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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