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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 275201316
Report Date: 09/25/2023
Date Signed: 10/09/2023 03:15:02 PM

Document Has Been Signed on 10/09/2023 03:15 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
FRESNO ASC, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:SALINAS SENIOR DAY PROGRAMFACILITY NUMBER:
275201316
ADMINISTRATOR:CHRISTINA HUNTFACILITY TYPE:
775
ADDRESS:408 SALINAS STREETTELEPHONE:
(831) 422-3999
CITY:SALINASSTATE: CAZIP CODE:
93901
CAPACITY: 21CENSUS: 10DATE:
09/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Program Manager, Siauro KatoaTIME COMPLETED:
04:15 PM
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Licensing Program Analysts (LPA) Sarah Hurt conducted an unannounced visit today for the facility’s annual inspection. LPA met with Program Manager, Siauro Katoa with Administrators Certificate expires 04/19/2025 . There are currently 10 clients receiving services at this location. LPA inspected the interior and the facility including the common activity areas, facility bathrooms bathrooms, and kitchen area.

Fire extinguisher is within the safety regulation period. Smoke alarms were tested and are operational. The home has a carbon monoxide detector and performs disaster drills as required. Water temperature was tested at 106 degrees. Toxins and cleaning supplies are locked and inaccessible.

There were no deficiencies observed or cited during today's inspection per California Code of Regulations, Title 22.

LPA's requested the following documents: LIC 500 Personnel Report, LIC 308 Designation of Administrative Responsibility, LIC 610 the Emergency Disaster Plan and copy of current Administrator’s Certificate to update the facility file. Listed documents shall be sent to Licensing.

Exit interview conducted with Program Manager, Siauro Katoa and copy of left at facility
SUPERVISORS NAME: Brenda Chan
LICENSING EVALUATOR NAME: Sarah Hurt
LICENSING EVALUATOR SIGNATURE: DATE: 09/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/25/2023
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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