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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 011440695
Report Date: 03/13/2025
Date Signed: 03/13/2025 11:00:29 AM

Document Has Been Signed on 03/13/2025 11:00 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
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:FAIRCLIFF HOMEFACILITY NUMBER:
011440695
ADMINISTRATOR/
DIRECTOR:		MCLAUGHLIN, TERESITAFACILITY TYPE:
735
ADDRESS:30965 FAIRCLIFF ST.TELEPHONE:
(510) 487-6317
CITY:HAYWARDSTATE: CAZIP CODE:
94544
CAPACITY: 6CENSUS: 5DATE:
03/13/2025
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Teresita Mclaughlin, Administrator TIME VISIT/
INSPECTION COMPLETED:
11:10 AM
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On 03/13/2025 at 9:05 AM, Licensing Program Analysts (LPAs) P. Manalo and K. Nguyen arrived unannounced to conduct 1-Year Annual Required inspection. LPAs met with Administrator, Teresita Mclaughlin, and explained the purpose of the visit. Administrator certificate is current. The facility’s fire clearance was approved for six (6) ambulatory only.

LPAs toured the facility including inside and out but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 4 bedrooms are occupied by the clients and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water. A comfortable temperature for clients is maintained at 70 degree Fahrenheit. LPAs observed lighting in all rooms are adequate for the comfort and safety of the clients. Hot water temperature in the shared clients’ bathroom was measured at 105.8 degree Fahrenheit. All toilets, hand washing and bathing are safe, sanitary and in operating condition. The supply of extra hygiene's was available for clients. There is a minimum of one week supply of nonperishable and 2-day perishables food supply.

Smoke detectors and carbon monoxide were in operating condition during visit. Fire extinguisher was last serviced on 12/10/2024. Emergency Disaster Drill was last posted on 03/13/2025. First aid kit was observed to be complete. Earthquake drill was last conducted on 01/31/2025.

At 9:22 AM, 5 of clients records were reviewed. At 9:46 AM, 4 staff records were reviewed. All staff have current first aid training and are associated to the facility. LPAs reviewed client's P&I money with log. LPAs reviewed a sample of client's medications.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2025
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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