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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015600506
Report Date: 03/04/2022
Date Signed: 03/04/2022 01:57:29 PM

Document Has Been Signed on 03/04/2022 01:57 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, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:ONE STEP CLOSERFACILITY NUMBER:
015600506
ADMINISTRATOR:BREWER, DELLA & AARONFACILITY TYPE:
775
ADDRESS:7622 MAC ARTHUR BLVD.TELEPHONE:
(510) 636-0216
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY: 100CENSUS: 30DATE:
03/04/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Grethel Davis, Program SupervisorTIME COMPLETED:
02:15 PM
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On 03/04/22 at 1:05 p.m., Licensing Program Analyst (LPA) G. Clark arrived unannounced to conduct Infection Control Inspection. LPA met with Program Supervisor Grethel Davis and explained the purpose of the visit.

During the Infection Control Inspection, LPA toured facility including but not limited to front entrance, screening station, hand washing stations, common areas, kitchen and side driveway. Facility is currently closed and is scheduled to open back up on March 14 and will limited capacity to 30 - 35 participants. Visitors policy is posted on the front entrance. There is one central entry point for universal screening for staff, participants and visitors. A sign-in policy, thermometer and hand sanitizer were observed at screening station. Cough/sneeze etiquette, social distancing and hand washing posters were observed. Facility staff were observed to be wearing proper PPE. Facility has a 30-day supply of PPEs maintained at central location and easily accessible for staff. Facility has a mitigation plan and maintains record of routine screening for participants and staff.

No deficiencies cited during visit. Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Gregory Clark
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2022
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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