Facility Evaluation Report

Licensing Program Analyst (LPA) Kelly Dulek conducted a Pre-Licensing Inspection with Applicant Representatives Jep Stokes, Antonio Reyes, Tiai Salanoa and Administrator Leopoldo (Leo) Vaca. An Application to operate a Social Rehabilitation Facility (SRF) was received by Community Care Licensing (CCL) on 03/10/2022. A Fire Clearance was approved for a maximum capacity of six (6) ambulatory residents on 05/12/2022.

The proposed physical plant is a two (2) story single family dwelling located in a residential neighborhood of Santa Rosa Valley, CA. A tour of the physical plant was conducted and the following observed:

COMMON AREAS: These include the Family Room and Dining Room. Additionally, the attached 3-car garage will be used as a Gym/Recreation Room. The common areas were furnished to accommodate a maximum capacity of six (6) residents. There is a fireplace in the Family Room as well as Family Therapy Room, which were observed to be adequately screened and Licensee Representative stated is disabled. There were no immediate hazards observed. A COVID-19 Screening & Hand Sanitizing Station was observed at the entrance to the facility. Fire extinguishers were observed throughout the facility; all were observed to be fully charged and last serviced 03/31/2022. At 11:00AM, hardwired combination carbon monoxide/smoke detectors were tested and were functional at the time of the visit.

TREATMENT/THERAPY, MEDICATION ROOM & OFFICE AREAS: There is a Group/Family Room, Family Therapy Room, Medication Room, and two (2) offices located on the ground floor. There is also a Learning Lab located on the second story as well as one (1) additional office. Medications are stored in a locked first floor Medication Room. The medication room has adequate locked storage, as well as a locked refrigerator. The 1st Aid Kit is stored in the Medication Room. The Offices are kept inaccessible to clients unless properly supervised.