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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002728
Report Date: 03/11/2022
Date Signed: 03/11/2022 01:51:23 PM


Document Has Been Signed on 03/11/2022 01:51 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:SOJOURNER TRUTH CENTERFACILITY NUMBER:
384002728
ADMINISTRATOR:ALCANTARA, TELMAFACILITY TYPE:
850
ADDRESS:1 CASHMERE STREETTELEPHONE:
(415) 401-1379
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:45CENSUS: 17DATE:
03/11/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:51 PM
MET WITH:Telma AlcantaraTIME COMPLETED:
03:22 PM
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Licensing Program Analyst (LPA) Sheran Lo conducted an unannounced case management inspection and met with the Director Telma Alcantara. The purpose of the inspection was explained. Present in the facility were 11 staff and 17 children in care.

Discussed during the inspection was related to Unusual Incident Report received on February 8, 2022 of child having a finger injured by staff closing door. Director understands and is in process on two sessions of meeting/training in the topic of supervision. Director will submit a signed agreement form of all staff involved.

***No deficiencies cited against the facility under CCR,Title 22, Div. 12, Chapt. 1.***

A copy of this report will be emailed to the Facilities Manager. This report must be available in the facility for public review. The facilities Manager was informed to contact the San Bruno Regional for any additional question at 650-266-8800 M-F, 8 AM-5 PM. For Rules and Regulations, visit the Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2022
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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