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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 572700610
Report Date: 05/11/2023
Date Signed: 05/11/2023 01:01:32 PM

Document Has Been Signed on 05/11/2023 01:01 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:WOODLAND COMMUNITY OPTIONSFACILITY NUMBER:
572700610
ADMINISTRATOR:PEFLEY, SHELLYFACILITY TYPE:
775
ADDRESS:45 W COURT STREETTELEPHONE:
(916) 283-8302
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 50CENSUS: 36DATE:
05/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Sara Heringer, Program Manager and
Judy Arrezola, Program Supervisor
TIME COMPLETED:
01:05 PM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual Inspection. The facility is licensed by the United Cerebral Palsy of Greater Sacramento, and works with Alta Regional Center and is partnered with UCP Transportation Services. There were 14 Staff and 36 clients at the facility at the time of arrival. The facility was closed for a short time due to a recent outbreak of Covid-19 but they are back operating with in-person participation; clients and staff wearing masks as a precaution, and continuing to monitor for symptoms. The facility has a Infection Control Plan.

LPA Nakagawa toured the facility and found it to be clean and a comfortable temperature. The water temperature measured between 105 -110 F in bathroom and utility sink faucets. The facility was well-organized and provided each client storage for their lunch (provided by client) and personal belongings. There were also areas provided to clients for quiet time. Clients were encouraged to socialize and participate in a variety of activities. At the time of visit, clients were making gifts for Mother's Day, playing games, enjoying Pet Therapy, and arts and crafts and games. Specially-trained staff helped clients with special dietary needs as the clients enjoyed lunch together.

The facility has 3 Fire Extinguishers that were fully charged and last inspected on 1/9/2023. The Fire Alarm System was inspected on 04/13/23 and found the smoke detector/carbon monoxide detectors to be operational.
There were no deficiencies found at the time of inspection. No citations issued.

Exit interview was conducted with Judy Arrezola, Program Supervisor and signed copy left at site.






SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2023
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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