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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 577004734
Report Date: 03/05/2024
Date Signed: 03/05/2024 12:50:03 PM

Document Has Been Signed on 03/05/2024 12:50 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:REACH ADULT DEVELOPMENT SITE #6FACILITY NUMBER:
577004734
ADMINISTRATOR:SUH, SEANFACILITY TYPE:
775
ADDRESS:921 JEFFERSON BLVDTELEPHONE:
(916) 203-6246
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY: 30CENSUS: 21DATE:
03/05/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jude Savon Program ManagerTIME COMPLETED:
12:55 PM
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LPAs Jill Nakagawa and Stefanie Mutialu arrived unannounced to conduct an Annual 1-Year Inspection at this facility and met with Program Director Jude Savon (JS). At the time of inspection there were nine (9) in-person clients with five (5) staff.

LPAs arrived at 9:00 AM to find clients arriving to in-person program. There are currently five (5) clients who have chosen to continue with Zoom/Virtual Program participation. The facility was found to be clean and at a comfortable temperature of 69 F - 72 F with all exits free from obstruction. Water temperature in the kitchen and two (2) bathrooms was 117 F. There are two fire extinguishers which were fully charged and last serviced on 6/14/2023. There were two carbon monoxide detectors which were operational. Fire Drills are conducted each month. Cleaning supplies and other toxins were locked in a closet inaccessible to clients. The kitchen is used for a cooking class two (2) days per week, but meals are not provided. Clients bring their own lunches each day which are stored in refrigerator.

LPAs observed a designated client break room for any client who needs a quiet space. There were several other areas for clients to use: small room for reading, drawing, yoga or individual class, a group room for watching movies, exercise, and other group activities. There is an outside area in the back of the building that has an area for basketball, gardening projects, picnics. The facility now has a large canopy to be used for shelter during activities during the warm, sunny weather. The facility was full of activities going on that involved each and every client. Continued on 809-C
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: REACH ADULT DEVELOPMENT SITE #6
FACILITY NUMBER: 577004734
VISIT DATE: 03/05/2024
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Continued from 809.....

Mandatory postings were found by the front door, including the Clients' Personal Rights.

No deficiencies found at the time of inspection.
No citations issued.
SUPERVISORS NAME: Kimberley Mota
LICENSING EVALUATOR NAME: Jill Nakagawa
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2024
LIC809 (FAS) - (06/04)
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