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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 576803973
Report Date: 06/02/2022
Date Signed: 06/02/2022 11:09:46 AM

Document Has Been Signed on 06/02/2022 11:09 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:GALILEO PLACE ADULT DAY PROGRAMFACILITY NUMBER:
576803973
ADMINISTRATOR:YOO, TANYAFACILITY TYPE:
775
ADDRESS:1909 GALILEO CT., STE. C.TELEPHONE:
(530) 758-5566
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY: 70CENSUS: 10DATE:
06/02/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Amy Meier, Program DirectorTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced on 6/2/22 at approximately 9:15 AM to perform a 1 Year Required Inspection focusing on Covid-19 Infection Control Protocols. The facility is still in the opening phase, with only 3 Saturday day programs held, however there are tours held daily. Daily operation of the day program is due to begin June 13.

Upon arrival, LPA was asked to take a rapid response Covid-19 test, as are all visitors to the facility. In addition, LPA was required to fill out a questionnaire including screening questions and information for contact tracing, and temperature taken. This information is all kept on file. Staff and residents are tested for Covid-19 before each session, screening questionnaire is completed, temperatures are taken. Information is logged.
There are signs posted at the entrance requiring masks, and there are signs posted throughout the facility washrooms reminding staff, visitors and clients how to wash their hands and to do so frequently (for 20 seconds). There is ample room in the facility to maintain social distancing while still allowing participation.

The kitchen has locked cupboards and drawers for hazardous and/or sharp materials. The laundry room does have a store of cleaning supplies, which are stored behind locked door. Dangerous items are stored and locked and inaccessible to clients. There was a supply of hygiene products and paper products available for clients, as well as a supply of PPE. All exterior doors are alarmed with all exits free from obstruction. The facility was clean, well-organized and a comfortable temperature of 70 F. The facility has a central fire alarm/sprinkler system which was last inspected on 07/02/21. There are 3 fire extinguishers which are fully charged and dated 12/20/21. There were no clients on the day of visit, however there were 3 staff, and a family (who were screened) who toured the facility. Facility submitted a Mitigation Plan on 03/30/22.

Exit interview conducted with Administrator, whose signature on this document confirms receipt.
No deficiencies cited during this inspection.


SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2022
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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