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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577003433
Report Date: 11/03/2021
Date Signed: 11/03/2021 01:43:31 PM

Document Has Been Signed on 11/03/2021 01:43 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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:TROPICAL VILLA-ARFFACILITY NUMBER:
577003433
ADMINISTRATOR:ALMARIO, ALMA Z.FACILITY TYPE:
735
ADDRESS:1334 VIENTO LANETELEPHONE:
(530) 662-3496
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 6CENSUS: 6DATE:
11/03/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Alma Almario, AdministratorTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Jill Nakagawa arrived unannounced to conduct an Annual Inspection focusing on Covid-19 guidelines. Covid-19 Infomational Postings were on the front door and throughout the house.

Administrator Alma Almario received LPA at the door, taking temperature and asking Covid-19 screening questions and documented them in a binder. Administrator then took LPA on a tour of the facility. There are 6 residents. All are participating in day programs either on line or in the community. Residents help with chores and participate in daily living activities, including caring for a new dog. Administrator was interested in knowing about raising chickens in the City of Woodland.

There is a hard-wired fire alarm system and 2 carbon monoxide detectors. There is also a fire extinguisher, last serviced 09/03/2021. The water temperature measured 108.8 F.

There was a month's supply of PPE and covered trash bins in case of isolation and quarantine of resident/s. There was also a month's supply of medications for each resident, which is stored in a locked medication cabinet.

Each staff person has a valid First Aid/CPR card.

No deficiencies during today's inspection.
No citations issued.
Exit interview conducted with the Administrator.



SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 11/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2021
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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