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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 079201370
Report Date: 05/09/2024
Date Signed: 05/09/2024 10:43:45 AM

Document Has Been Signed on 05/09/2024 10:43 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
CCLD Regional Office, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:SANTO NINO HOMEFACILITY NUMBER:
079201370
ADMINISTRATOR/
DIRECTOR:		MATEL, MARIA T.FACILITY TYPE:
735
ADDRESS:23 GLEN CANYON CTTELEPHONE:
(925) 267-3732
CITY:PITTSBURGSTATE: CAZIP CODE:
94565
CAPACITY: 6CENSUS: 0DATE:
05/09/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Maria Matel, Licensee/AdministratorTIME VISIT/
INSPECTION COMPLETED:
10:50 AM
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On 5/9/2024 at 9:35AM Licensing Program Analyst (LPA) L. Hall conducted an announced pre-licensing inspection and met with Maria Matel, Licensee/Administrator.

LPA toured the bedrooms, bathrooms, common living areas, kitchen, and backyard. There is sufficient lighting around the facility. Residents rooms are not equipped with the proper furniture and lighting. Residents rooms do not have proper bedding and linens for the use. Bathrooms were equipped with grab bars, but no non skid mats or shower curtains. Living room had only two (2) recliners. Hallways are free of obstruction. Smoke detectors and Carbon Monoxide detector are equipped around the facility. Hot water temperature is measured at 135.5 degrees Fahrenheit. No bodies of water present.

Issues were noted during inspection. LPA observed that facility is not ready to be licensed. This report will be submitted to the Central Applications Unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.
SUPERVISORS NAME: Harpreet Humpal
LICENSING EVALUATOR NAME: Laura Hall
LICENSING EVALUATOR SIGNATURE: DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/09/2024
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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