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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 572700610
Report Date: 05/20/2024
Date Signed: 05/20/2024 12:28:18 PM

Document Has Been Signed on 05/20/2024 12:28 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/
DIRECTOR:
PEFLEY, SHELLYFACILITY TYPE:
775
ADDRESS:45 W COURT STREETTELEPHONE:
(916) 283-8302
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 50CENSUS: 45DATE:
05/20/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Carlette Phipps, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual Inspection and was welcomed by Program Supervisor Judy Arrezola. Program Manager Carlette Phipps arrived shortly. 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 17 Staff and 45 clients at the facility at the time of arrival. The facility has a Infection Control Plan.

LPA Nakagawa toured the facility and found it to be clean and a comfortable temperature between 68-70 F. The water temperature measured between 111 -112 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. Trained staff help clients with special dietary needs and a licensed nurse is on staff to help clients with medication management and feedings.

The facility has 3 Fire Extinguishers that were fully charged and last inspected on 12/27/2023. The Fire Alarm System is due to be inspected and Licensee will provide inspection results to CCL.

There were no deficiencies found at the time of inspection. No citations issued.

Exit interview was conducted with Carlette Phipps, Program Manager.

SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 05/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2024
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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