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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577004052
Report Date: 03/05/2025
Date Signed: 03/05/2025 11:17:37 AM

Document Has Been Signed on 03/05/2025 11:17 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:IMPACT CENTER, LLC-WEST SACRAMENTOFACILITY NUMBER:
577004052
ADMINISTRATOR/
DIRECTOR:		GRIFFIN, JOETTAFACILITY TYPE:
775
ADDRESS:1834 TERMINAL STREETTELEPHONE:
(916) 373-9740
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY: 45CENSUS: 20DATE:
03/05/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Patty Blas, Program ManagerTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 03/05/2025, Licensing Program Analyst Jill Nakagawa conducted 1 year unannounced required inspection and met with Program Manager Patty Blas. There were (20) clients in attendance at the facility during this inspection.

The Facility was found to be clean, orderly, with all exits free from obstruction. The facility is a very large space and uses zonal heating. Toxins are stored in locked cabinets in a locked closet in staff kitchen. There was a sufficient supply of hygiene products, cleaners, and paper products for use as needed. All bathrooms had paper towels and soap, and covered trash bins. All postings were up and visible to all as required. Facility has a sufficient supply of personal protective equipment (PPE). Four (4) fire extinguishers were serviced and charged on 03/13/2024 and an appointment to be serviced is scheduled for 03/12/2025. Fire Alarm system was inspected on 03/26/2024 by West Sacramento Fire Department.

The Day Program provides an active schedule for the participants: outings to bowling, movies, restaurants and a variety of other places. The facility encourages physical activity with daily exercise. Clients bring their own lunches each day and bring their own money for activities. Transportation is provided.
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No deficiencies during today's inspection.
No citations issued.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2025
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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